Since the introduction of general anaesthesia, over 170 years ago, it has generally been assumed that the effects of anaesthesia and surgery on the brain are fully reversible, transient and leave no lasting effects. However, this assumption has been somewhat at odds with reported deterioration in thinking and behaviour which have been observed for over 100 years. During the early days of anaesthesia, all efforts were focused on decreasing mortality and improving safety. Anaesthesia has been remarkably successful in this endeavour and is now focusing on longer term adverse outcomes. One of the most frequent is the impaired cognitive ability that follows anaesthesia and surgery in many individuals over the age of 65.
The aim of this study is to clarify the changes in brain biomarker proteins with anaesthesia and surgery in cardiac and non-cardiac surgery, and their relationship to neurocognitive outcomes. It is proposed to assay the plasma biomarkers NFL and tau in serial blood samples taken from individuals over the age of 65 years scheduled for elective cardiac and non-cardiac surgery.
The researchers will also administer a cognitive test battery at baseline and again at three months in order to identify neurocognitive disorder and assess daily for delirium during hospital admission. In this manner they will have the ability to link these neurological biomarkers with cognitive outcomes and compare the biomarker and clinical phenotype between those undergoing cardiac and non-cardiac procedures.
St Vincent’s Hospital, Melbourne
Associate Professor Brendan Silbert, Associate Professor Lisbeth Evered and Professor David Scott
The project was awarded $68,847 funding through the ANZCA research grants program for 2020.
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