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AAI-guided anaesthesia is associated with lower incidence of 24-h MMSE < 25 and may impact the IL-6 response
Orebro University Hospital. Department of Anaesthesiology and Intensive Care.
Department of Anaesthesiology and Intensive Care, University Hospital, Örebro, Sweden.
Department of Anaesthesiology and Intensive Care, University Hospital, Örebro, Sweden.
Orebro University Hospital. Department of Anaesthesiology and Intensive Care; Department of Anaesthesiology and Intensive Care, Institution for Clinical Science at The Karolinska Institutet, Danderyds University Hospital, Stockholm, Sweden.
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2014 (English)In: International Journal of Surgery, ISSN 1743-9191, E-ISSN 1743-9159, Vol. 12, no 4, 290-295 p.Article in journal (Refereed) Published
Abstract [en]

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 (p = 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.

Place, publisher, year, edition, pages
Elsevier, 2014. Vol. 12, no 4, 290-295 p.
Keyword [en]
Cognitive decline, General anaesthesia, Auditory evoked potential (AEP) monitoring, Minor surgery, IL-6
National Category
Surgery
Identifiers
URN: urn:nbn:se:oru:diva-56500DOI: 10.1016/j.ijsu.2014.02.002ISI: 000333531300005PubMedID: 24509399Scopus ID: 2-s2.0-84897405651OAI: oai:DiVA.org:oru-56500DiVA: diva2:1082481
Note

Funding Agency:

Scientific committee of Örebro county council

Available from: 2017-03-16 Created: 2017-03-16 Last updated: 2017-03-16Bibliographically approved

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