Intravenous Steroid Use in the Prevention of Postoperative Cognitive Dysfunction

Abstract

Postoperative cognitive dysfunction (POCD) is described as anesthesia’s silent side effect, occurring in nearly 10% of patients 65 years and older. Evidence suggests a link between POCD and the release of inflammatory cytokines during surgery, including but not limited to, the peripheral inflammatory markers, interleukin-1Beta (IL-1B) and tumor necrosis factor-a (TNF-a). Intravenous steroids have been shown to decrease the release of these inflammatory biomarkers. A systemic review of the literature was conducted evaluating the use of prophylactic intravenous steroids in reducing the incidence of POCD. A general knowledge base deficit existed amongst the AdventHealth University (AHU) Student Registered Nurse Anesthetists (SRNAs) regarding POCD. To address the problem, an Educational PowerPoint presentation was developed with the objective to increase the knowledge base of 22 AHU SRNAs. An identical 10 question multiple-choice pre-test and posttest was administered to assess baseline knowledge and effectiveness of the presentation. Statistical analysis was performed on the mean pre-test and posttest scores which determine the students’ knowledge base on the anesthetic implications of POCD significantly increased after the administration of a 30 minute educational PowerPoint. The statistical analysis revealed scores increased on average from the pre-test to posttest by nearly 45%.

Description

Keywords

Postoperative cognitive dysfunction, dexamethasone, IL-1B, IL-6, TNF-alpha, S100B protein

Citation

DOI