Effects of anesthetics on early postoperative cognitive outcome and intraoperative cerebral oxygen balance in patients undergoing lung surgery: a randomized clinical trial.

• Material Type: 博士論文
• ISSN: 0832-610X
• Title: Effects of anesthetics on early postoperative cognitive outcome and intraoperative cerebral oxygen balance in patients undergoing lung surgery: a randomized clinical trial.
• Volume: 63 10
• Author/Editor: Egawa, Junji; Inoue, Satoki; Nishiwada, Tadashi; Tojo, Takashi; Kimura, Michitaka; Kawaguchi, Takeshi; Taniguchi, Shigeki; Furuya, Hitoshi; Kawaguchi, Masahiko
• Author Heading: Egawa, Junji; Inoue, Satoki; Nishiwada, Tadashi; Tojo, Takashi; Kimura, Michitaka; Kawaguchi, Takeshi; Taniguchi, Shigeki; Furuya, Hitoshi; Kawaguchi, Masahiko
• Publication, Distribution, etc.: Springer
• Publication Date: 2016-10; 63 10
• Publication Date (W3CDTF): 2016-10
• Alternative Title: 肺外科手術における術後早期の高次脳機能および術中脳酸素需給バランスに対する麻酔薬の効果 : ランダム化比較試験
• Periodical title: Canadian journal of anaesthesia
• Degree grantor/type: 奈良県立医科大学
• Date Granted: 2017-03-15
• Date Granted (W3CDTF): 2017-03-15
• Dissertation Number: 乙第1397号
• Degree Type: 博士（医学）
• Conferring No. (Dissertation): 乙第1397号
• Text Language Code: eng
• Target Audience: 一般
• Note (General): type:Thesis; PURPOSE: One-lung ventilation (OLV) may impair cerebral oxygen balance and induce postoperative cognitive dysfunction (POCD). It is unclear whether the type of anesthetic influences the incidence of POCD in patients undergoing OLV. This prospective study compared the incidence of POCD and intraoperative cerebral oxygen desaturation in OLV patients anesthetized with propofol vs sevoflurane during lung surgery. METHODS: There were 148 participants enrolled in this study and randomized equally to either the propofol or the sevoflurane group. Anesthesia was maintained with either propofol or sevoflurane combined in both groups with fentanyl and epidural anesthesia. Regional cerebral oxygen saturation (rSO2), jugular bulb venous oxygen saturation (SjO2), and the incidence of cerebral oxygen desaturation (rSO2 or SjO2 < 50% or rSO2 < 80% of baseline) were measured during anesthesia. Cognitive function was assessed using seven neurocognitive tests two days preoperatively, five days postoperatively (primary outcome), and three months postoperatively. Bivariable and multivariable regression analyses were conducted to identify factors associated with POCD. RESULTS: Rates of POCD did not differ statistically between groups five days postoperatively (propofol, 16/72 patients; sevoflurane, 24/72 patients; RR, 0.67; 95% CI, 0.39 to 1.15; P = 0.14) or three months postoperatively (propofol, 9/60 patients; sevoflurane, 12/58 patients; RR, 0.73; 95% CI, 0.33 to 1.59; P = 0.42). Only three subjects per group showed intraoperative cerebral oxygen desaturation. Multivariable regression analysis revealed older age as an independent predictor of POCD. CONCLUSIONS: No statistically significant difference in the incidence of POCD could be detected between the sevoflurane and propofol anesthesia groups. Postoperative cognitive dysfunction was relatively frequent following OLV in both groups. (REGISTRATION NUMBER: UMIN 000002826).; 博士（医学）・乙第1397号・平成29年3月15日; © Canadian Anesthesiologists' Society 2016; This is a post-peer-review, pre-copyedit version of an article published in Canadian journal of anaesthesia. The final authenticated version is available online at: http://dx.doi.org/10.1007/s12630-016-0700-4.; identifier:Canadian journal of anaesthesia Vol.63 p.10 p.1161-1169 (2016 Oct); identifier:0832610X; identifier:http://ginmu.naramed-u.ac.jp/dspace/handle/10564/3330; identifier:Canadian journal of anaesthesia, 63(10): 1161-1169
• DOI: info:doi/10.1007/s12630-016-0700-4; https://doi.org/info:doi/10.1007/s12630-016-0700-4
• Persistent ID (NDL): info:ndljp/pid/11091908; https://dl.ndl.go.jp/pid/11091908
• Collection: 障害者向け資料
• Collection (Materials For Handicapped People:1): テキストデータ
• Collection (particular): 国立国会図書館デジタルコレクション > デジタル化資料 > 博士論文; https://dl.ndl.go.jp/collections/A00014
• Acquisition Basis: 博士論文（自動収集）
• Date Accepted (W3CDTF): 2018-05-04T12:13:37+09:00
• Format (IMT): application/pdf
• Access Restrictions: 国立国会図書館内限定公開
• Service for the Digitized Contents Transmission Service: 図書館・個人送信対象外
• Availability of remote photoduplication service: 可
• Periodical Title (URI): http://hdl.handle.net/10564/3330
• Data Provider (Database): 国立国会図書館 : 国立国会図書館デジタルコレクション; https://dl.ndl.go.jp

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