AAI-guided anaesthesia is associated with lower incidence of 24-h MMSE < 25 and may impact the IL-6 response
(2014) In International Journal of Surgery 12(4). p.290-295- Abstract
Introduction: Trauma stress and neuro-inflammation caused by surgery/anaesthesia releases cytokines. This study analysed impact of Auditory Evoked Potential Index (AAI) depth-of-anaesthesia titration on the early plasma IL-6 release after eye surgery under general anaesthesia. Method: This is a subgroup analysis of a prospective randomized study on the effect of auditory evoked potential guided anaesthesia for eye surgery. Plasma IL-6 levels taken before, 5 and 24 h after end of surgery from 450 patients undergoing elective ophthalmic surgery under desflurane anaesthesia were analysed. Minimal mental state examination (MMSE) was also tested at 24-h. Results: IL- 6 increased significantly at both 5 and further at 24 h after surgery (3.2,... (More)
Introduction: Trauma stress and neuro-inflammation caused by surgery/anaesthesia releases cytokines. This study analysed impact of Auditory Evoked Potential Index (AAI) depth-of-anaesthesia titration on the early plasma IL-6 release after eye surgery under general anaesthesia. Method: This is a subgroup analysis of a prospective randomized study on the effect of auditory evoked potential guided anaesthesia for eye surgery. Plasma IL-6 levels taken before, 5 and 24 h after end of surgery from 450 patients undergoing elective ophthalmic surgery under desflurane anaesthesia were analysed. Minimal mental state examination (MMSE) was also tested at 24-h. Results: IL- 6 increased significantly at both 5 and further at 24 h after surgery (3.2, 4.5 and 5.1 base-line, 5 and 24-h respectively), the IL-6 increase showed different patterns between the 2 groups; IL-6 was significantly increased in the control group of patients between preoperative baseline and 24 h after surgery (4p = 0.008) also between 5 h and 24 h, (p = 0.006) after surgery while the AAI-group had only minor non-significant changes. The 18 patients that showed a 24-h MMSE score less than 25 had a significant higher 24-h IL-6 compared to the 390 patients with a MMSE score > 24 (p = 0.002). Conclusion: The IL-6 increase after surgery was less pronounced in patients where anaesthesia was titrated by AAI compared to anaesthesia adjusted on clinical signs only. IL-6 were also found to be higher in patients with a MMSE < 25 at 24-h. Further studies are warranted evaluating the role of depth of anaesthesia monitoring on the risk for early cognitive impairment and neuro-inflammation. Trial registration: Clinicaltrials.gov identifier: NA/study were conducted between January 2005-April 2008.
(Less)
- author
- Jildenstål, Pether K. LU ; Hallén, Jan L. ; Rawal, Narinder ; Berggren, Lars and Jakobsson, Jan G.
- publishing date
- 2014-01-01
- type
- Contribution to journal
- publication status
- published
- keywords
- Auditory evoked potential (AEP) monitoring, Cognitive decline, General anaesthesia, IL-6, Minor surgery
- in
- International Journal of Surgery
- volume
- 12
- issue
- 4
- pages
- 6 pages
- publisher
- Elsevier
- external identifiers
-
- scopus:84897405651
- pmid:24509399
- ISSN
- 1743-9191
- DOI
- 10.1016/j.ijsu.2014.02.002
- language
- English
- LU publication?
- no
- id
- 2e2890b6-3a7e-4a4d-aa57-58d0e31c9803
- date added to LUP
- 2020-09-27 20:52:16
- date last changed
- 2024-05-01 18:27:24
@article{2e2890b6-3a7e-4a4d-aa57-58d0e31c9803,
abstract = {{<p>Introduction: Trauma stress and neuro-inflammation caused by surgery/anaesthesia releases cytokines. This study analysed impact of Auditory Evoked Potential Index (AAI) depth-of-anaesthesia titration on the early plasma IL-6 release after eye surgery under general anaesthesia. Method: This is a subgroup analysis of a prospective randomized study on the effect of auditory evoked potential guided anaesthesia for eye surgery. Plasma IL-6 levels taken before, 5 and 24 h after end of surgery from 450 patients undergoing elective ophthalmic surgery under desflurane anaesthesia were analysed. Minimal mental state examination (MMSE) was also tested at 24-h. Results: IL- 6 increased significantly at both 5 and further at 24 h after surgery (3.2, 4.5 and 5.1 base-line, 5 and 24-h respectively), the IL-6 increase showed different patterns between the 2 groups; IL-6 was significantly increased in the control group of patients between preoperative baseline and 24 h after surgery (4p = 0.008) also between 5 h and 24 h, (p = 0.006) after surgery while the AAI-group had only minor non-significant changes. The 18 patients that showed a 24-h MMSE score less than 25 had a significant higher 24-h IL-6 compared to the 390 patients with a MMSE score > 24 (p = 0.002). Conclusion: The IL-6 increase after surgery was less pronounced in patients where anaesthesia was titrated by AAI compared to anaesthesia adjusted on clinical signs only. IL-6 were also found to be higher in patients with a MMSE < 25 at 24-h. Further studies are warranted evaluating the role of depth of anaesthesia monitoring on the risk for early cognitive impairment and neuro-inflammation. Trial registration: Clinicaltrials.gov identifier: NA/study were conducted between January 2005-April 2008.</p>}},
author = {{Jildenstål, Pether K. and Hallén, Jan L. and Rawal, Narinder and Berggren, Lars and Jakobsson, Jan G.}},
issn = {{1743-9191}},
keywords = {{Auditory evoked potential (AEP) monitoring; Cognitive decline; General anaesthesia; IL-6; Minor surgery}},
language = {{eng}},
month = {{01}},
number = {{4}},
pages = {{290--295}},
publisher = {{Elsevier}},
series = {{International Journal of Surgery}},
title = {{AAI-guided anaesthesia is associated with lower incidence of 24-h MMSE < 25 and may impact the IL-6 response}},
url = {{http://dx.doi.org/10.1016/j.ijsu.2014.02.002}},
doi = {{10.1016/j.ijsu.2014.02.002}},
volume = {{12}},
year = {{2014}},
}