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      A clinical review of inhalation anesthesia with sevoflurane: from early research to emerging topics

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          Abstract

          A large number of studies during the past two decades have demonstrated the efficacy and safety of sevoflurane across patient populations. Clinical researchers have also investigated the effects of sevoflurane, its hemodynamic characteristics, its potential protective effects on several organ systems, and the incidence of delirium and cognitive deficiency. This review examines the clinical profiles of sevoflurane and other anesthetic agents, and focuses upon emerging topics such as organ protection, postoperative cognitive deficiency and delirium, and novel ways to improve postanesthesia outcomes.

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          Predictors of cognitive dysfunction after major noncardiac surgery.

          Terri Monk, B Craig Weldon, Cyndi Garvan … (2008)
          The authors designed a prospective longitudinal study to investigate the hypothesis that advancing age is a risk factor for postoperative cognitive dysfunction (POCD) after major noncardiac surgery and the impact of POCD on mortality in the first year after surgery. One thousand sixty-four patients aged 18 yr or older completed neuropsychological tests before surgery, at hospital discharge, and 3 months after surgery. Patients were categorized as young (18-39 yr), middle-aged (40-59 yr), or elderly (60 yr or older). At 1 yr after surgery, patients were contacted to determine their survival status. At hospital discharge, POCD was present in 117 (36.6%) young, 112 (30.4%) middle-aged, and 138 (41.4%) elderly patients. There was a significant difference between all age groups and the age-matched control subjects (P < 0.001). At 3 months after surgery, POCD was present in 16 (5.7%) young, 19 (5.6%) middle-aged, and 39 (12.7%) elderly patients. At this time point, the prevalence of cognitive dysfunction was similar between age-matched controls and young and middle-aged patients but significantly higher in elderly patients compared to elderly control subjects (P < 0.001). The independent risk factors for POCD at 3 months after surgery were increasing age, lower educational level, a history of previous cerebral vascular accident with no residual impairment, and POCD at hospital discharge. Patients with POCD at hospital discharge were more likely to die in the first 3 months after surgery (P = 0.02). Likewise, patients who had POCD at both hospital discharge and 3 months after surgery were more likely to die in the first year after surgery (P = 0.02). Cognitive dysfunction is common in adult patients of all ages at hospital discharge after major noncardiac surgery, but only the elderly (aged 60 yr or older) are at significant risk for long-term cognitive problems. Patients with POCD are at an increased risk of death in the first year after surgery.
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            Relationship between intraoperative mean arterial pressure and clinical outcomes after noncardiac surgery: toward an empirical definition of hypotension.

            Michael Walsh, Philip Devereaux, Amit X Garg … (2013)
            Intraoperative hypotension may contribute to postoperative acute kidney injury (AKI) and myocardial injury, but what blood pressures are unsafe is unclear. The authors evaluated the association between the intraoperative mean arterial pressure (MAP) and the risk of AKI and myocardial injury.
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              General anesthesia, sleep, and coma.

              Robert S Schwartz, Emery Brown, Ralph Lydic … (2011)
              Article 0 comments Cited 358 times – based on 0 reviews     Review now
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                Author and article information

                Contributors
                Jorge D. Brioni: 847-937-9079 , jorge.d.brioni@abbvie.com
                Journal
                Journal ID (nlm-ta): J Anesth
                Journal ID (iso-abbrev): J Anesth
                Title: Journal of Anesthesia
                Publisher: Springer Japan (Tokyo )
                ISSN (Print): 0913-8668
                ISSN (Electronic): 1438-8359
                Publication date (Electronic): 5 June 2017
                Publication date PMC-release: 5 June 2017
                Publication date (Print): 2017
                Volume: 31
                Issue: 5
                Pages: 764-778
                Affiliations
                [1 ]ISNI 0000 0004 0572 4227, GRID grid.431072.3, Global Medical Affairs, , AbbVie, Inc., ; 1 N. Waukegan Rd., ABV1, North Chicago, IL 60064 USA
                [2 ]Asklepios Hospital St. Georg, Lohmühlenstraße 5, D-20099 Hamburg, Germany
                Article
                Publisher ID: 2375
                DOI: 10.1007/s00540-017-2375-6
                PMC ID: 5640726
                PubMed ID: 28585095
                SO-VID: 16bf3e47-cbb9-4a18-9e2c-7d076c0bb6c7
                Copyright © © The Author(s) 2017
                License:

                Open AccessThis article is distributed under the terms of the Creative Commons Attribution 4.0 International License ( http://creativecommons.org/licenses/by/4.0/), which permits unrestricted use, distribution, and reproduction in any medium, provided you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons license, and indicate if changes were made.

                History
                Date received : 15 February 2017
                Date accepted : 20 May 2017
                Funding
                Funded by: FundRef http://dx.doi.org/10.13039/100006483, AbbVie;
                Categories
                Subject: Review Article
                Custom metadata
                issue-copyright-statement © Japanese Society of Anesthesiologists 2017

                ScienceOpen disciplines: Anesthesiology & Pain management
                Keywords: volatile anesthetic,cardiac protection,postoperative cognitive dysfunction,emergence,delirium
                Data availability:
                ScienceOpen disciplines: Anesthesiology & Pain management
                Keywords: volatile anesthetic, cardiac protection, postoperative cognitive dysfunction, emergence, delirium

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