Abstract:
BACKGROUND:Postoperative cognitive decline (pCD) occurs frequently (6 to 30%) after carotid endarterectomy (CEA), although there are no exact estimates and risk factors are still unclear. OBJECTIVE:The objective of this study was to determine pCD incidence and risk factors in CEA patients. DESIGN:We performed a systematic review and meta-analysis of both randomised and nonrandomised trials following Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines. DATA SOURCES:We searched Cochrane, PubMed/Medline and Embase databases from the date of database inception to 1 December 2018. ELIGIBILITY CRITERIA:We selected longitudinal studies including CEA patients with both pre-operative and postoperative cognitive assessments. Primary outcome was pCD incidence, differentiating delayed neurocognitive recovery (dNCR) and postoperative neurocognitive disorder (pNCD). dNCR and pNCD incidences were expressed as proportions of cases on total CEA sample and pooled as weighted estimates from proportions. Postoperative delirium was excluded from the study design. Secondary outcomes were patient-related (i.e. age, sex, diabetes, hypertension, contralateral stenosis, pre-operative symptoms, dyslipidaemia and statin use) and procedure-related (i.e. hyperperfusion, cross-clamping duration and shunting placement) risk factors for pCD. We estimated odds ratios (ORs) and mean differences through a random effects model by using STATA 13.1 and RevMan 5.3. RESULTS:Our search identified 5311 publications and 60 studies met inclusion criteria reporting a total of 4823 CEA patients. dNCR and pNCD incidence were 20.5% [95% confidence interval (CI), 17.1 to 24.0] and 14.1% (95% CI, 9.5 to 18.6), respectively. pCD risk was higher in patients experiencing hyperperfusion during surgery (OR, 35.68; 95% CI, 16.64 to 76.51; P < 0.00001; I = 0%), whereas dNCR risk was lower in patients taking statins before surgery (OR, 0.56; 95% CI, 0.41 to 0.77; P = 0.0004; I = 19%). Sensitivity analysis revealed that longer cross-clamping duration was a predictor for dNCR (mean difference, 5.25 min; 95% CI, 0.87 to 9.63; P = 0.02; I = 49%). CONCLUSION:We found high incidences of dNCR (20.5%) and pNCD (14.1%) after CEA. Hyperperfusion seems to be a risk factor for pCD, whereas the use of statins is associated with a lower risk of dNCR. An increased cross-clamping duration could be a risk factor for dNCR. TRIAL REGISTRATION:This systematic review was registered in the International Prospective Register of Systematic Reviews (CDR42017073633).
journal_name
Eur J Anaesthesioljournal_title
European journal of anaesthesiologyauthors
Aceto P,Lai C,De Crescenzo F,Crea MA,Di Franco V,Pellicano GR,Perilli V,Lai S,Papanice D,Sollazzi Ldoi
10.1097/EJA.0000000000001130subject
Has Abstractpub_date
2020-11-01 00:00:00pages
1066-1074issue
11eissn
0265-0215issn
1365-2346journal_volume
37pub_type
杂志文章abstract:BACKGROUND:Control of blood pressure remains a key goal of peri-operative care, because hypotension is associated with adverse outcomes after surgery. OBJECTIVES:We explored whether increased vigilance afforded by intra-arterial blood pressure monitoring may be associated with less morbidity after surgery. DESIGN:A p...
journal_title:European journal of anaesthesiology
pub_type: 杂志文章
doi:10.1097/EJA.0000000000001443
更新日期:2021-01-12 00:00:00
abstract::Sevoflurane has been reported to generate oxygen free radicals. We have investigated whether sevoflurane or isoflurane enhances oxygen free radical formation in the post-ischaemic reperfused heart. An isolated rat heart-lung preparation was used. Thirty male Wistar rats were allocated to four groups: control, no drug,...
journal_title:European journal of anaesthesiology
pub_type: 杂志文章
doi:10.1046/j.1365-2346.1998.00352.x
更新日期:1998-09-01 00:00:00
abstract:BACKGROUND AND OBJECTIVE:Most therapeutic options for postoperative delirium are only symptom oriented; therefore, the best approach remains prevention. The aim of this study was to identify predisposing and precipitating factors for early postoperative delirium. METHODS:A total of 1002 patients were screened for deli...
journal_title:European journal of anaesthesiology
pub_type: 杂志文章
doi:10.1097/EJA.0b013e3283335cee
更新日期:2010-05-01 00:00:00
abstract:BACKGROUND AND OBJECTIVES:To determine the visibility of pleural lung sliding in alveolar-interstitial syndrome (AIS) in patients on mechanical ventilation at two different time points, as a confirmatory ultrasonographic method for excluding pneumothorax. METHODS:Fifty-two mechanically ventilated patients in the semir...
journal_title:European journal of anaesthesiology
pub_type: 杂志文章
doi:10.1097/EJA.0b013e32833feb40
更新日期:2011-04-01 00:00:00
abstract:BACKGROUND AND AIM:This study assessed the accuracy of using capnography with a modified, hollow gum elastic bougie in predicting tracheal intubation, and its effectiveness as a method of apnoeic oxygenation. METHODS:Patients were randomly allocated to having the gum elastic bougie inserted, under anaesthesia, in the ...
journal_title:European journal of anaesthesiology
pub_type: 临床试验,杂志文章,随机对照试验
doi:10.1046/j.0265-0215.2000.00774.x
更新日期:2001-01-01 00:00:00
abstract::The rate of failed spinal anaesthesia, defined as the need for unplanned general anaesthesia, was evaluated in a prospective study involving 137 patients undergoing transurethral resection of the prostate (TURP). The incidence of sensations at the operative site which did not require general anaesthesia was also evalu...
journal_title:European journal of anaesthesiology
pub_type: 临床试验,杂志文章,随机对照试验
doi:
更新日期:1992-01-01 00:00:00
abstract:BACKGROUND:Intrathecal ketamine produces a short period of analgesia with stable haemodynamics. Midazolam with bupivacaine prolongs the duration of analgesia when administered intrathecally but does not prevent hypotension. The objective of this study was to assess the effect of a combination of intrathecal bupivacaine...
journal_title:European journal of anaesthesiology
pub_type: 杂志文章,随机对照试验
doi:10.1017/S0265021507002645
更新日期:2008-04-01 00:00:00
abstract:BACKGROUND:Movement-evoked pain is more severe than pain at rest and is likely to interfere more with functional recovery after surgery. OBJECTIVE:To compare triple vs. double nonopioid perioperative analgesic regimens in women undergoing abdominal hysterectomy. DESIGN:A randomised, parallel design, double-blind cont...
journal_title:European journal of anaesthesiology
pub_type: 杂志文章,随机对照试验
doi:10.1097/EJA.0000000000000190
更新日期:2015-04-01 00:00:00
abstract::The effects of protamine (6 mg kg-1) injected after heparin (5 mg kg-1) have been studied in five groups of five New Zealand white rabbits. Group I was treated with the sequence heparin-protamine and group II with protamine alone. The animals of groups III and IV received respectively intravenous indomethacin (3 mg kg...
journal_title:European journal of anaesthesiology
pub_type: 杂志文章
doi:
更新日期:1992-07-01 00:00:00
abstract::The post-operative period is particularly dangerous for obese patients. The aim of this study was to compare the immediate post-operative course after either laparoscopic or open gastroplasty. We studied retrospectively 20 and 14 consecutive patients who underwent laparoscopic or open adjustable silicone gastric bandi...
journal_title:European journal of anaesthesiology
pub_type: 杂志文章
doi:10.1046/j.1365-2346.1999.00510.x
更新日期:1999-06-01 00:00:00
abstract::The incidence of sore throat after the use of the laryngeal mask was assessed with a randomized trial in 839 patients. Sore throat occurred more often in women, older patients or after multiple insertion attempts. It was found that the frequency in women, but not in men, was lowered from 11.9% to 3.9% (P = 0.012) by r...
journal_title:European journal of anaesthesiology
pub_type: 临床试验,杂志文章,随机对照试验
doi:
更新日期:1998-03-01 00:00:00
abstract::The thrombogenicity of polyethylene, silicone and polyurethane central venous catheters was compared in a prospective clinical, phlebographic and post-mortem study in 52 patients. The incidence of central venous thrombosis was high with polyethylene catheters (70%), but much lower with silicone (20%) and with polyuret...
journal_title:European journal of anaesthesiology
pub_type: 临床试验,杂志文章,随机对照试验
doi:
更新日期:1984-12-01 00:00:00
abstract:BACKGROUND:The C-MAC D-blade is a new, highly angulated, videolaryngoscope blade designed for use in patients with difficult airways. Directing a tracheal tube into the trachea with any indirect viewing laryngoscope can be difficult, even with a good view of the laryngeal inlet. OBJECTIVE:To determine which introducin...
journal_title:European journal of anaesthesiology
pub_type: 杂志文章
doi:10.1097/EJA.0000000000000070
更新日期:2015-06-01 00:00:00
abstract::Ninety-eight patients scheduled for elbow, forearm, wrist or hand surgery were allocated randomly to one of two different techniques of brachial plexus block, both using the axillary approach. The blocks were all performed at the level of the insertion of the lateral margin of the pectoralis major muscle on the humeru...
journal_title:European journal of anaesthesiology
pub_type: 临床试验,杂志文章,随机对照试验
doi:
更新日期:1995-07-01 00:00:00
abstract:CONTEXT:Previous research has shown that most patients are satisfied with their anaesthetic care. For those who are not the causes may be multifactorial including dissatisfaction with surgical outcomes. OBJECTIVES:We aimed to identify whether quality of recovery after anaesthesia and surgery measured in multiple domai...
journal_title:European journal of anaesthesiology
pub_type: 杂志文章,多中心研究
doi:10.1097/EJA.0b013e328357e584
更新日期:2013-03-01 00:00:00
abstract:BACKGROUND AND OBJECTIVE:the objective of this study was to assess whether antiemetic drugs metoclopramide and diphenhydramine, administered together as opposed to alone, can have better efficacy in preventing postoperative nausea and vomiting when added to patient-controlled morphine analgesia. PATIENTS AND METHODS:d...
journal_title:European journal of anaesthesiology
pub_type: 杂志文章,随机对照试验
doi:10.1097/EJA.0b013e32833f53b8
更新日期:2010-12-01 00:00:00
abstract::Simulation is often used for training personnel in activities where the consequences of inappropriate actions are serious. We report a realistic training simulator, which can reproduce practically all potential malfunctions in the anaesthetic machine. Using actual standard equipment (Dameca 10750), the interior of the...
journal_title:European journal of anaesthesiology
pub_type: 杂志文章
doi:
更新日期:1993-01-01 00:00:00
abstract:BACKGROUND AND OBJECTIVE:ProSeal Laryngeal Mask Airway (PLMA) and Laryngeal Tube Suction (LTS), supraglottic airway devices allowing gastric drainage, were compared in this prospective, randomized study for airway management under conditions with elevated intra-abdominal pressure induced by capnoperitoneum. METHODS:Fi...
journal_title:European journal of anaesthesiology
pub_type: 临床试验,杂志文章,随机对照试验
doi:10.1017/s0265021505000220
更新日期:2005-02-01 00:00:00
abstract:BACKGROUND AND OBJECTIVE:Recent evidence indicates that platelet function may recover more rapidly after cessation of aspirin therapy than previously thought. The present study evaluated the effect of aspirin on platelet function using platelet aggregometry in healthy individuals and in aspirin-treated patients schedul...
journal_title:European journal of anaesthesiology
pub_type: 杂志文章
doi:10.1097/EJA.0b013e328335b354
更新日期:2010-07-01 00:00:00
abstract:BACKGROUND:Arterial pressure monitoring using the a continuous noninvasive arterial pressure (CNAP) device during general anaesthesia is known to be interchangeable with continuous invasive arterial pressure (CIAP) monitoring. Agreement with invasive measurements in cardiovascular postsurgical intensive care patients h...
journal_title:European journal of anaesthesiology
pub_type: 临床试验,杂志文章
doi:10.1097/EJA.0000000000000136
更新日期:2015-01-01 00:00:00
abstract:BACKGROUND AND OBJECTIVE:Little has been documented about the development of pain after ophthalmic surgery. This study was designed to assess the incidence and severity of postoperative pain following ophthalmic surgery, and to identify key factors independently associated with development of such pain. METHODS:In a p...
journal_title:European journal of anaesthesiology
pub_type: 杂志文章
doi:10.1017/s0265021504002042
更新日期:2004-02-01 00:00:00
abstract:BACKGROUND AND OBJECTIVE:When continuous infusions of neuromuscular blocking drugs are administered during lengthy interventions and no routine antagonism of their effects is applied, there is a dramatic incidence of residual curarization. We have examined whether the use of neuromuscular transmission monitoring result...
journal_title:European journal of anaesthesiology
pub_type: 临床试验,杂志文章,随机对照试验
doi:10.1017/s026502150300142x
更新日期:2003-11-01 00:00:00
abstract:BACKGROUND:Post-anaesthetic shivering is one of the most common complications, occurring in 5-65% of patients recovering from general anaesthesia and 33% of patients receiving epidural anaesthesia. Our objective was to investigate the efficacy of intraoperative dexmedetomidine infusion on postoperative shivering. METH...
journal_title:European journal of anaesthesiology
pub_type: 杂志文章,随机对照试验
doi:10.1017/S0265021507003110
更新日期:2008-05-01 00:00:00
abstract::A hemiarthroplasty for femoral neck fracture was successfully performed under combined epidural anaesthesia and light general anaesthesia before phaeochromocytoma removal. Pre-operative therapy was managed with doxazosin, enalapril and diltiazem. Peri-operative management facilitated maintenance of stable haemodynamic...
journal_title:European journal of anaesthesiology
pub_type: 杂志文章
doi:
更新日期:1993-11-01 00:00:00
abstract::Ringer's solution expands blood volume by between 20% and 25% in awake volunteers, but little is known about its volume effect during general anaesthesia. In 35 men with a mean age of 70 years, the power of various intra-operative factors to change blood volume as estimated by the haemoglobin dilution method were anal...
journal_title:European journal of anaesthesiology
pub_type: 杂志文章
doi:10.1046/j.1365-2346.1998.00313.x
更新日期:1998-07-01 00:00:00
abstract::The relative potencies of the intravenous anaesthetics propofol and thiopentone have been investigated by finding the dose necessary to produce unconsciousness in approximately 30%, 50% and 80% of patients. The estimated potency of propofol to thiopentone was 1:1.604 as obtained by the probit method of analysis which ...
journal_title:European journal of anaesthesiology
pub_type: 临床试验,杂志文章,随机对照试验
doi:
更新日期:1986-01-01 00:00:00
abstract::Diabetes mellitus is the most common metabolic disease and its incidence is increasing. New classifications have been recently proposed based upon a better knowledge of pathogenesis, mechanisms of glucose transport and insulin resistance. The perioperative care of diabetic patients is less dependent on blood-glucose c...
journal_title:European journal of anaesthesiology
pub_type: 杂志文章,评审
doi:10.1046/j.0265-0215.2001.00876.x
更新日期:2001-05-01 00:00:00
abstract:BACKGROUND:Pulse pressure variation (PPV) is a well known dynamic preload indicator of fluid responsiveness. However, its usefulness in open-chest conditions remains controversial. OBJECTIVE:We evaluated whether augmented PPV during a Valsalva manoeuvre can predict fluid responsiveness after sternotomy. DESIGN:A pros...
journal_title:European journal of anaesthesiology
pub_type: 临床试验,杂志文章
doi:10.1097/EJA.0000000000000613
更新日期:2017-05-01 00:00:00
abstract::We investigated the effects of controlled hypotension with haemodilution under isoflurane anaesthesia on splanchnic perfusion in elderly patients. We determined the intramucosal pH using gastric tonometry in 28 patients scheduled for hip surgery. Patients without cardiac disease were assigned to two groups according t...
journal_title:European journal of anaesthesiology
pub_type: 临床试验,杂志文章
doi:10.1046/j.1365-2346.1999.00531.x
更新日期:1999-08-01 00:00:00
abstract::A 72-year-old woman had a minitracheostomy inserted for sputum retention. This was undertaken by a relatively junior resident who opted to use an early model minitracheostomy kit Minitrach II. The following day the patients condition deteriorated and intubation was warranted, at which time it was apparent to senior st...
journal_title:European journal of anaesthesiology
pub_type: 杂志文章
doi:10.1046/j.1365-2346.1999.00530.x
更新日期:1999-08-01 00:00:00