Potential Neuroprotective Role of Sugammadex: A Clinical Study on Cognitive Function Assessment in an Enhanced Recovery After Cardiac Surgery Approach and an Experimental Study
Por:
V. MUEDRA, V. RODILLA, M. LLANSOLA, A. AGUSTI, C. PLA, A. CANTO and V. HERNANDEZ-RABAZA
Publicada:
21 feb 2022
Resumen:
BackgroundPostoperative cognitive dysfunction affects the quality of recovery, particularly affecting the elderly, and poses a burden on the health system. We hypothesize that the use of sugammadex (SG) could optimize the quality of postoperative cognitive function and overall recovery through a neuroprotective effect. MethodsA pilot observational study on patients undergoing cardiac surgery with enhanced recovery after cardiac surgery (ERACS) approach, was designed to compare SG-treated (n = 14) vs. neostigmine (NG)-treated (n = 7) patients. The Postoperative Quality Recovery Scale (PQRS) was used at different times to evaluate cognitive function and overall recovery of the patients. An online survey among anesthesiologists on SG use was also performed. Additionally, an animal model study was designed to explore the effects of SG on the hippocampus. ResultsSugammadex (SG) was associated with favorable postoperative recovery in cognitive domains particularly 30 days after surgery in patients undergoing aortic valve replacement by cardiopulmonary bypass and the ERACS approach; however, it failed to demonstrate a short-term decrease in length of intensive care unit (ICU) and hospital stay. The survey information indicated a positive appreciation of SG recovery properties. SG reverts postoperative memory deficit and induces the expression of anti-inflammatory microglial markers. ConclusionThe results show a postoperative cognitive improvement by SG treatment in patients undergoing aortic valve replacement procedure by the ERACS approach. Additionally, experimental data from an animal model of mild surgery confirm the cognitive effect of SG and suggest a potential effect over glia cells as an underlying mechanism.
Filiaciones:
V. MUEDRA:
CEU Univ, Univ CEU Cardenal Herrera, Inst Biomed Sci, Dept Med & Surg,Fac Hlth Sci, Valencia, Spain
Univ La Ribera Hosp, Dept Anesthesiol Intens Care Unit & Pain Therapy, Valencia, Spain
V. RODILLA:
CEU Univ, Univ CEU Cardenal Herrera, Inst Biomed Sci, Dept Pharm,Fac Hlth Sci, Valencia, Spain
:
Ctr Invest Principe Felipe CIPF, Neurobiol Lab, Valencia, Spain
A. AGUSTI:
Spanish Council Sci Res IATA CSIC, Inst Agrochemistry & Food Technol, Dept Microbial Ecol, Nutr & Hlth Res Unit, Valencia, Spain
C. PLA:
Univ La Ribera Hosp, Dept Anesthesiol Intens Care Unit & Pain Therapy, Valencia, Spain
A. CANTO:
CEU Univ, Univ CEU Cardenal Herrera, Inst Biomed Sci, Dept Biomed Sci,Fac Hlth Sci, Valencia, Spain
V. HERNANDEZ-RABAZA:
CEU Univ, Univ CEU Cardenal Herrera, Inst Biomed Sci, Dept Biomed Sci,Fac Hlth Sci, Valencia, Spain
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