Optimised Anaesthesia to Reduce Post Operative Cognitive Decline (POCD) in Older Patients Undergoing Elective Surgery, a Randomised Controlled Trial

Clive Ballard; Emma Jones; Nathan Gauge; Dag Aarsland; Odd Bjarte Nilsen; Brian K. Saxby; David Lowery; Anne Corbett; Keith Wesnes; Eirini Katsaiti; James Arden; Derek Amaoko; Nicholas Prophet; Balaji Purushothaman; David Green

doi:10.1371/journal.pone.0037410

Optimised Anaesthesia to Reduce Post Operative Cognitive Decline (POCD) in Older Patients Undergoing Elective Surgery, a Randomised Controlled Trial

Clive Ballard^*, Emma Jones, Nathan Gauge, Dag Aarsland, Odd Bjarte Nilsen, Brian K. Saxby, David Lowery, Anne Corbett, Keith Wesnes, Eirini Katsaiti, James Arden, Derek Amaoko, Nicholas Prophet, Balaji Purushothaman, David Green

^*Corresponding author for this work

Research output: Contribution to journal › Article › peer-review

198 Citations (Scopus)

Abstract

Background: The study determined the one year incidence of post operative cognitive decline (POCD) and evaluated the effectiveness of an intra-operative anaesthetic intervention in reducing post-operative cognitive impairment in older adults (over 60 years of age) undergoing elective orthopaedic or abdominal surgery.

Methods and Trial Design: The design was a prospective cohort study with a nested randomised, controlled intervention trial, using intra-operative BiSpectral index and cerebral oxygen saturation monitoring to enable optimisation of anaesthesia depth and cerebral oxygen saturation in older adults undergoing surgery.

Results: In the 52 week prospective cohort study (192 surgical patients and 138 controls), mild (chi(2) = 17.9 p

Conclusion: POCD is common and persistent in older adults following surgery. The results of the nested RCT indicate the potential benefits of intra-operative monitoring of anaesthetic depth and cerebral oxygenation as a pragmatic intervention to reduce post-operative cognitive impairment.

Original language	English
Article number	e37410
Pages (from-to)	N/A
Number of pages	9
Journal	PL o S One
Volume	7
Issue number	6
DOIs	https://doi.org/10.1371/journal.pone.0037410
Publication status	Published - 15 Jun 2012

Keywords

MAJOR ABDOMINAL-SURGERY
TRAUMATIC BRAIN-INJURY
GENERAL-ANESTHESIA
ELDERLY-PATIENTS
NONCARDIAC SURGERY
BISPECTRAL INDEX
DYSFUNCTION
IMPAIRMENT
DEMENTIA
PREDICTION

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Ballard, C., Jones, E., Gauge, N., Aarsland, D., Nilsen, O. B., Saxby, B. K., Lowery, D., Corbett, A., Wesnes, K., Katsaiti, E., Arden, J., Amaoko, D., Prophet, N., Purushothaman, B., & Green, D. (2012). Optimised Anaesthesia to Reduce Post Operative Cognitive Decline (POCD) in Older Patients Undergoing Elective Surgery, a Randomised Controlled Trial. PL o S One , 7(6), N/A. Article e37410. https://doi.org/10.1371/journal.pone.0037410

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abstract = "Background: The study determined the one year incidence of post operative cognitive decline (POCD) and evaluated the effectiveness of an intra-operative anaesthetic intervention in reducing post-operative cognitive impairment in older adults (over 60 years of age) undergoing elective orthopaedic or abdominal surgery.Methods and Trial Design: The design was a prospective cohort study with a nested randomised, controlled intervention trial, using intra-operative BiSpectral index and cerebral oxygen saturation monitoring to enable optimisation of anaesthesia depth and cerebral oxygen saturation in older adults undergoing surgery.Results: In the 52 week prospective cohort study (192 surgical patients and 138 controls), mild (chi(2) = 17.9 pConclusion: POCD is common and persistent in older adults following surgery. The results of the nested RCT indicate the potential benefits of intra-operative monitoring of anaesthetic depth and cerebral oxygenation as a pragmatic intervention to reduce post-operative cognitive impairment.",

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author = "Clive Ballard and Emma Jones and Nathan Gauge and Dag Aarsland and Nilsen, {Odd Bjarte} and Saxby, {Brian K.} and David Lowery and Anne Corbett and Keith Wesnes and Eirini Katsaiti and James Arden and Derek Amaoko and Nicholas Prophet and Balaji Purushothaman and David Green",

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Ballard, C , Jones, E, Gauge, N, Aarsland, D, Nilsen, OB, Saxby, BK, Lowery, D, Corbett, A, Wesnes, K, Katsaiti, E, Arden, J, Amaoko, D, Prophet, N, Purushothaman, B & Green, D 2012, 'Optimised Anaesthesia to Reduce Post Operative Cognitive Decline (POCD) in Older Patients Undergoing Elective Surgery, a Randomised Controlled Trial', PL o S One , vol. 7, no. 6, e37410, pp. N/A. https://doi.org/10.1371/journal.pone.0037410

TY - JOUR

T1 - Optimised Anaesthesia to Reduce Post Operative Cognitive Decline (POCD) in Older Patients Undergoing Elective Surgery, a Randomised Controlled Trial

AU - Ballard, Clive

AU - Jones, Emma

AU - Gauge, Nathan

AU - Aarsland, Dag

AU - Nilsen, Odd Bjarte

AU - Saxby, Brian K.

AU - Lowery, David

AU - Corbett, Anne

AU - Wesnes, Keith

AU - Katsaiti, Eirini

AU - Arden, James

AU - Amaoko, Derek

AU - Prophet, Nicholas

AU - Purushothaman, Balaji

AU - Green, David

PY - 2012/6/15

Y1 - 2012/6/15

N2 - Background: The study determined the one year incidence of post operative cognitive decline (POCD) and evaluated the effectiveness of an intra-operative anaesthetic intervention in reducing post-operative cognitive impairment in older adults (over 60 years of age) undergoing elective orthopaedic or abdominal surgery.Methods and Trial Design: The design was a prospective cohort study with a nested randomised, controlled intervention trial, using intra-operative BiSpectral index and cerebral oxygen saturation monitoring to enable optimisation of anaesthesia depth and cerebral oxygen saturation in older adults undergoing surgery.Results: In the 52 week prospective cohort study (192 surgical patients and 138 controls), mild (chi(2) = 17.9 pConclusion: POCD is common and persistent in older adults following surgery. The results of the nested RCT indicate the potential benefits of intra-operative monitoring of anaesthetic depth and cerebral oxygenation as a pragmatic intervention to reduce post-operative cognitive impairment.

AB - Background: The study determined the one year incidence of post operative cognitive decline (POCD) and evaluated the effectiveness of an intra-operative anaesthetic intervention in reducing post-operative cognitive impairment in older adults (over 60 years of age) undergoing elective orthopaedic or abdominal surgery.Methods and Trial Design: The design was a prospective cohort study with a nested randomised, controlled intervention trial, using intra-operative BiSpectral index and cerebral oxygen saturation monitoring to enable optimisation of anaesthesia depth and cerebral oxygen saturation in older adults undergoing surgery.Results: In the 52 week prospective cohort study (192 surgical patients and 138 controls), mild (chi(2) = 17.9 pConclusion: POCD is common and persistent in older adults following surgery. The results of the nested RCT indicate the potential benefits of intra-operative monitoring of anaesthetic depth and cerebral oxygenation as a pragmatic intervention to reduce post-operative cognitive impairment.

KW - MAJOR ABDOMINAL-SURGERY

KW - TRAUMATIC BRAIN-INJURY

KW - GENERAL-ANESTHESIA

KW - ELDERLY-PATIENTS

KW - NONCARDIAC SURGERY

KW - BISPECTRAL INDEX

KW - DYSFUNCTION

KW - IMPAIRMENT

KW - DEMENTIA

KW - PREDICTION

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DO - 10.1371/journal.pone.0037410

M3 - Article

SN - 1932-6203

VL - 7

SP - N/A

JO - PL o S One

JF - PL o S One

IS - 6

M1 - e37410

ER -

Optimised Anaesthesia to Reduce Post Operative Cognitive Decline (POCD) in Older Patients Undergoing Elective Surgery, a Randomised Controlled Trial

Abstract

Keywords

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