Citicoline in the prevention of postoperative cognitive dysfunction during total intravenous anesthesia

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At present there is strong evidence of negative influence of general anesthesia on the brain, with the development of postoperative cognitive dysfunction (POCD). The lack of generally accepted approaches to medicamentous prevention of POCD raises the question of intraoperative cerebral protection. Forty female patients (aged 17–69 years) who underwent laparoscopic cholecystectomy under total intravenous anesthesia (TIVA) based on propofol and fentanyl were included in the randomized double-blind placebo-controlled study. Twenty patients were
randomly assigned to the main group and were given intraoperatively citicoline (Ceraxon, 1000 mg i.v.), and 20 patients received placebo. Hemodynamics, Harvard standard of patient’s safety, bispectral and perfusion indexes were intraoperatively monitored. Neuropsychological testing including tables of Schulte, the 10 words recall test and the Hospital Anxiety and Depression Scale (HADS) were performed preoperatively, as well as on day 1 and day 3 after surgery. Both groups were matched by demographics, coexisting pathology, preoperative cognitive status and anxiety. Anesthesia was adequate with equivalent demand of anesthetics in all patients. Post-anesthesia
recovery period parameters were significantly better in the treatment group compared to placebo (p<0.05). On day 1, POCD was detected in 20% of patients in the treatment group and in 50% in the placebo group (p<0.05). On day 3, improvement of long-term memory (by 56%) and attention (by 14.3%) was observed in the Ceraxon group comparing to placebo (p<0.05). HADS results on day 1 did not show any significant difference between the groups, but a positive trend of the decrease of anxiety in the treatment group was observed. Thus, Ceraxon used
intraoperatively does not influence on anesthetic consumption, significantly improves the course of postanesthetic recovery and prevents the development of POCD in the postoperative period

About the authors

A. M. Ovezov

Moscow Regional Research and Clinical Institute named after M.F. Vladimirsky

Author for correspondence.
Russian Federation

M. A. Lobov

Moscow Regional Research and Clinical Institute named after M.F. Vladimirsky

Russian Federation

E. D. Nad’kina

Moscow Regional Research and Clinical Institute named after M.F. Vladimirsky

Russian Federation

P. S. Myatchin

Moscow Regional Research and Clinical Institute named after M.F. Vladimirsky

Russian Federation

M. V. Panteleeva

Moscow Regional Research and Clinical Institute named after M.F. Vladimirsky

Russian Federation

A. V. Knyazev

Moscow Regional Research and Clinical Institute named after M.F. Vladimirsky

Russian Federation


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Copyright (c) 2017 Ovezov A.M., Lobov M.A., Nad’kina E.D., Myatchin P.S., Panteleeva M.V., Knyazev A.V.

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