Effects of single low dose of dexamethasone before noncardiac and nonneurologic surgery and general anesthesia on postoperative cognitive dysfunction : a phase III double blind, randomized clinical trial
Autor(a) principal: | |
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Data de Publicação: | 2016 |
Outros Autores: | , , , , , , , , , , |
Tipo de documento: | Artigo |
Idioma: | eng |
Título da fonte: | Repositório Institucional da UFRGS |
Texto Completo: | http://hdl.handle.net/10183/224613 |
Resumo: | Postoperative cognitive dysfunction (POCD) is a multifactorial adverse event most frequently in elderly patients. This study evaluated the effect of dexamethasone on POCD incidence after noncardiac and nonneurologic surgery. METHODS: One hundred and forty patients (ASA I-II; age 60–87 years) took part in a prospective phase III, double blind, randomized study involving the administration or not of 8 mg of IV dexamethasone before general anesthesia under bispectral index (BIS) between 35–45 or 46–55. Neuropsychological tests were applied preoperatively and on the 3rd, 7th, 21st, 90th and 180th days after surgery and compared with normative data. S100β was evaluated before and 12 hours after induction of anesthesia. The generalized estimating equations (GEE) method was applied, followed by the posthoc Bonferroni test considering P<0.05 as significant. RESULTS: On the 3rd postoperative day, POCD was diagnosed in 25.2% and 15.3% of patients receiving dexamethasone, BIS 35–45, and BIS 46–55 groups, respectively. Meanwhile, POCD was present in 68.2% and 27.2% of patients without dexamethasone, BIS 35–45 and BIS 46–55 groups (p<0.0001). Neuropsychological tests showed that dexamethasone associated to BIS 46–55 decreased the incidence of POCD, especially memory and executive function. The administration of dexamethasone might have prevented the postoperative increase in S100β serum levels. CONCLUSION: Dexamethasone can reduce the incidence of POCD in elderly patients undergoing surgery, especially when associated with BIS 46–55. The effect of dexamethasone on S100β might be related with some degree of neuroprotection. |
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Valentin, Lívia Stocco SanchesPereira, Valéria Fontenelle AngelimPietrobon, RicardoSchmidt, André PratoOses, Jean PierrePortela, Luis Valmor CruzSouza, Diogo Onofre Gomes deVissoci, João Ricardo NickenigLuz, Vinicius Fernando daTrintoni, Leticia Maria de Araujo de SouzaNielsen, Karen C.Carmona, Maria José Carvalho2021-07-28T04:39:12Z20161932-6203http://hdl.handle.net/10183/224613001008310Postoperative cognitive dysfunction (POCD) is a multifactorial adverse event most frequently in elderly patients. This study evaluated the effect of dexamethasone on POCD incidence after noncardiac and nonneurologic surgery. METHODS: One hundred and forty patients (ASA I-II; age 60–87 years) took part in a prospective phase III, double blind, randomized study involving the administration or not of 8 mg of IV dexamethasone before general anesthesia under bispectral index (BIS) between 35–45 or 46–55. Neuropsychological tests were applied preoperatively and on the 3rd, 7th, 21st, 90th and 180th days after surgery and compared with normative data. S100β was evaluated before and 12 hours after induction of anesthesia. The generalized estimating equations (GEE) method was applied, followed by the posthoc Bonferroni test considering P<0.05 as significant. RESULTS: On the 3rd postoperative day, POCD was diagnosed in 25.2% and 15.3% of patients receiving dexamethasone, BIS 35–45, and BIS 46–55 groups, respectively. Meanwhile, POCD was present in 68.2% and 27.2% of patients without dexamethasone, BIS 35–45 and BIS 46–55 groups (p<0.0001). Neuropsychological tests showed that dexamethasone associated to BIS 46–55 decreased the incidence of POCD, especially memory and executive function. The administration of dexamethasone might have prevented the postoperative increase in S100β serum levels. CONCLUSION: Dexamethasone can reduce the incidence of POCD in elderly patients undergoing surgery, especially when associated with BIS 46–55. The effect of dexamethasone on S100β might be related with some degree of neuroprotection.application/pdfengPLoS ONE. San Francisco. Vol. 11, no. 5 (May 2016), e0152308, 12 f.DexametasonaPeríodo pós-operatórioDisfunção cognitivaEffects of single low dose of dexamethasone before noncardiac and nonneurologic surgery and general anesthesia on postoperative cognitive dysfunction : a phase III double blind, randomized clinical trialEstrangeiroinfo:eu-repo/semantics/articleinfo:eu-repo/semantics/publishedVersioninfo:eu-repo/semantics/openAccessreponame:Repositório Institucional da UFRGSinstname:Universidade Federal do Rio Grande do Sul (UFRGS)instacron:UFRGSTEXT001008310.pdf.txt001008310.pdf.txtExtracted Texttext/plain33399http://www.lume.ufrgs.br/bitstream/10183/224613/2/001008310.pdf.txtf0b99ae8f7a932791f0f9d42eef5ab0bMD52ORIGINAL001008310.pdfTexto completo (inglês)application/pdf1002219http://www.lume.ufrgs.br/bitstream/10183/224613/1/001008310.pdf0b374a8df7e96c37872f9d6a3463d233MD5110183/2246132023-01-18 06:01:39.44245oai:www.lume.ufrgs.br:10183/224613Repositório de PublicaçõesPUBhttps://lume.ufrgs.br/oai/requestopendoar:2023-01-18T08:01:39Repositório Institucional da UFRGS - Universidade Federal do Rio Grande do Sul (UFRGS)false |
dc.title.pt_BR.fl_str_mv |
Effects of single low dose of dexamethasone before noncardiac and nonneurologic surgery and general anesthesia on postoperative cognitive dysfunction : a phase III double blind, randomized clinical trial |
title |
Effects of single low dose of dexamethasone before noncardiac and nonneurologic surgery and general anesthesia on postoperative cognitive dysfunction : a phase III double blind, randomized clinical trial |
spellingShingle |
Effects of single low dose of dexamethasone before noncardiac and nonneurologic surgery and general anesthesia on postoperative cognitive dysfunction : a phase III double blind, randomized clinical trial Valentin, Lívia Stocco Sanches Dexametasona Período pós-operatório Disfunção cognitiva |
title_short |
Effects of single low dose of dexamethasone before noncardiac and nonneurologic surgery and general anesthesia on postoperative cognitive dysfunction : a phase III double blind, randomized clinical trial |
title_full |
Effects of single low dose of dexamethasone before noncardiac and nonneurologic surgery and general anesthesia on postoperative cognitive dysfunction : a phase III double blind, randomized clinical trial |
title_fullStr |
Effects of single low dose of dexamethasone before noncardiac and nonneurologic surgery and general anesthesia on postoperative cognitive dysfunction : a phase III double blind, randomized clinical trial |
title_full_unstemmed |
Effects of single low dose of dexamethasone before noncardiac and nonneurologic surgery and general anesthesia on postoperative cognitive dysfunction : a phase III double blind, randomized clinical trial |
title_sort |
Effects of single low dose of dexamethasone before noncardiac and nonneurologic surgery and general anesthesia on postoperative cognitive dysfunction : a phase III double blind, randomized clinical trial |
author |
Valentin, Lívia Stocco Sanches |
author_facet |
Valentin, Lívia Stocco Sanches Pereira, Valéria Fontenelle Angelim Pietrobon, Ricardo Schmidt, André Prato Oses, Jean Pierre Portela, Luis Valmor Cruz Souza, Diogo Onofre Gomes de Vissoci, João Ricardo Nickenig Luz, Vinicius Fernando da Trintoni, Leticia Maria de Araujo de Souza Nielsen, Karen C. Carmona, Maria José Carvalho |
author_role |
author |
author2 |
Pereira, Valéria Fontenelle Angelim Pietrobon, Ricardo Schmidt, André Prato Oses, Jean Pierre Portela, Luis Valmor Cruz Souza, Diogo Onofre Gomes de Vissoci, João Ricardo Nickenig Luz, Vinicius Fernando da Trintoni, Leticia Maria de Araujo de Souza Nielsen, Karen C. Carmona, Maria José Carvalho |
author2_role |
author author author author author author author author author author author |
dc.contributor.author.fl_str_mv |
Valentin, Lívia Stocco Sanches Pereira, Valéria Fontenelle Angelim Pietrobon, Ricardo Schmidt, André Prato Oses, Jean Pierre Portela, Luis Valmor Cruz Souza, Diogo Onofre Gomes de Vissoci, João Ricardo Nickenig Luz, Vinicius Fernando da Trintoni, Leticia Maria de Araujo de Souza Nielsen, Karen C. Carmona, Maria José Carvalho |
dc.subject.por.fl_str_mv |
Dexametasona Período pós-operatório Disfunção cognitiva |
topic |
Dexametasona Período pós-operatório Disfunção cognitiva |
description |
Postoperative cognitive dysfunction (POCD) is a multifactorial adverse event most frequently in elderly patients. This study evaluated the effect of dexamethasone on POCD incidence after noncardiac and nonneurologic surgery. METHODS: One hundred and forty patients (ASA I-II; age 60–87 years) took part in a prospective phase III, double blind, randomized study involving the administration or not of 8 mg of IV dexamethasone before general anesthesia under bispectral index (BIS) between 35–45 or 46–55. Neuropsychological tests were applied preoperatively and on the 3rd, 7th, 21st, 90th and 180th days after surgery and compared with normative data. S100β was evaluated before and 12 hours after induction of anesthesia. The generalized estimating equations (GEE) method was applied, followed by the posthoc Bonferroni test considering P<0.05 as significant. RESULTS: On the 3rd postoperative day, POCD was diagnosed in 25.2% and 15.3% of patients receiving dexamethasone, BIS 35–45, and BIS 46–55 groups, respectively. Meanwhile, POCD was present in 68.2% and 27.2% of patients without dexamethasone, BIS 35–45 and BIS 46–55 groups (p<0.0001). Neuropsychological tests showed that dexamethasone associated to BIS 46–55 decreased the incidence of POCD, especially memory and executive function. The administration of dexamethasone might have prevented the postoperative increase in S100β serum levels. CONCLUSION: Dexamethasone can reduce the incidence of POCD in elderly patients undergoing surgery, especially when associated with BIS 46–55. The effect of dexamethasone on S100β might be related with some degree of neuroprotection. |
publishDate |
2016 |
dc.date.issued.fl_str_mv |
2016 |
dc.date.accessioned.fl_str_mv |
2021-07-28T04:39:12Z |
dc.type.driver.fl_str_mv |
Estrangeiro info:eu-repo/semantics/article |
dc.type.status.fl_str_mv |
info:eu-repo/semantics/publishedVersion |
format |
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http://hdl.handle.net/10183/224613 |
dc.identifier.issn.pt_BR.fl_str_mv |
1932-6203 |
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001008310 |
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1932-6203 001008310 |
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http://hdl.handle.net/10183/224613 |
dc.language.iso.fl_str_mv |
eng |
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dc.relation.ispartof.pt_BR.fl_str_mv |
PLoS ONE. San Francisco. Vol. 11, no. 5 (May 2016), e0152308, 12 f. |
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