AAI-guided anaesthesia is associated with lower incidence of 24-h MMSE < 25 and may impact the IL-6 response
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
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.
Cognitive decline, General anaesthesia, Auditory evoked potential (AEP) monitoring, Minor surgery, IL-6
IdentifiersURN: urn:nbn:se:oru:diva-56500DOI: 10.1016/j.ijsu.2014.02.002ISI: 000333531300005PubMedID: 24509399ScopusID: 2-s2.0-84897405651OAI: oai:DiVA.org:oru-56500DiVA: diva2:1082481
Scientific committee of Örebro county council2017-03-162017-03-162017-03-16Bibliographically approved