Qi Zhou1, Lili Yu2, Chunping Yin1, Qi Zhang3, Xupeng Wang1, Kai Kang4, Decheng Shao5, Qiujun Wang6. 1. Department of Anesthesiology, The Third Hospital of Hebei Medical University, Shijiazhuang, China. 2. Department of Anesthesiology, Cangzhou Central Hospital, Cangzhou, China. 3. Department of Anesthesiology, Hebei Children's Hospital Affiliated to Hebei Medical University, Shijiazhuang, China. 4. Department of Joint Surgery, The Third Hospital of Hebei Medical University, Shijiazhuang, China. 5. Department of Sport Medicine, The Third Hospital of Hebei Medical University, Shijiazhuang, China. 6. Department of Anesthesiology, The Third Hospital of Hebei Medical University, Shijiazhuang, China. wangqiujunsy@163.com.
Abstract
BACKGROUND: The aim of this study was to investigate whether transauricular vagus nerve stimulation (taVNS) could decrease the incidence of delayed neurocognitive recovery (dNCR) in elderly adults after total joint arthroplasty (TJA). METHODS: A prospective, randomized, double-blind, sham-controlled trial was designed. In total, 124 elderly patients undergoing TJA were enrolled and randomly assigned to taVNS group (n = 62), who received taVNS at 1 h before anesthetic induction until the end of surgery, or sham stimulation (SS) group (n = 62), who received SS in the same manner. Neuropsychological batteries were performed before and at 1 week after surgery to assess the incidence of dNCR. Blood samples were collected before surgery and at 1 day after surgery to detect the activity of cholinesterase (AChE and BChE), as well as the levels of inflammatory factors (TNF-α, IL-1β, IL-6, and HMGB1) and brain damage factor S100β. RESULTS: Of 124 patients, 119 completed 1 week neuropsychological tests. The incidence of dNCR was significantly decreased in taVNS group [10% (6/60)] compared with the SS group [27.1% (16/59)] (P < 0.05). Patients who received taVNS had lower blood levels of AChE, BChE, IL-6, HMGB1, and S100β after surgery (P < 0.05), as compared with those in the SS group. There was no difference in TNF-α between the two groups. CONCLUSION: The taVNS can decrease the incidence of dNCR after TJA in elderly patients, which may be related to the inhibition of inflammatory cytokine production and the reduction of cholinesterase activity.
BACKGROUND: The aim of this study was to investigate whether transauricular vagus nerve stimulation (taVNS) could decrease the incidence of delayed neurocognitive recovery (dNCR) in elderly adults after total joint arthroplasty (TJA). METHODS: A prospective, randomized, double-blind, sham-controlled trial was designed. In total, 124 elderly patients undergoing TJA were enrolled and randomly assigned to taVNS group (n = 62), who received taVNS at 1 h before anesthetic induction until the end of surgery, or sham stimulation (SS) group (n = 62), who received SS in the same manner. Neuropsychological batteries were performed before and at 1 week after surgery to assess the incidence of dNCR. Blood samples were collected before surgery and at 1 day after surgery to detect the activity of cholinesterase (AChE and BChE), as well as the levels of inflammatory factors (TNF-α, IL-1β, IL-6, and HMGB1) and brain damage factor S100β. RESULTS: Of 124 patients, 119 completed 1 week neuropsychological tests. The incidence of dNCR was significantly decreased in taVNS group [10% (6/60)] compared with the SS group [27.1% (16/59)] (P < 0.05). Patients who received taVNS had lower blood levels of AChE, BChE, IL-6, HMGB1, and S100β after surgery (P < 0.05), as compared with those in the SS group. There was no difference in TNF-α between the two groups. CONCLUSION: The taVNS can decrease the incidence of dNCR after TJA in elderly patients, which may be related to the inhibition of inflammatory cytokine production and the reduction of cholinesterase activity.
Authors: L Evered; B Silbert; D S Knopman; D A Scott; S T DeKosky; L S Rasmussen; E S Oh; G Crosby; M Berger; R G Eckenhoff Journal: Anesthesiology Date: 2018-11 Impact factor: 7.892
Authors: Terri G Monk; B Craig Weldon; Cyndi W Garvan; Duane E Dede; Maria T van der Aa; Kenneth M Heilman; Joachim S Gravenstein Journal: Anesthesiology Date: 2008-01 Impact factor: 7.892
Authors: Jacob Steinmetz; Karl Bang Christensen; Thomas Lund; Nicolai Lohse; Lars S Rasmussen Journal: Anesthesiology Date: 2009-03 Impact factor: 7.892