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Obesity Surgery
Published in: Obesity Surgery 1/2023

Open Access 05-11-2022 | Obesity | Original Contributions

Effects of Peripheral Neural Blocks in Laparoscopic Sleeve Gastrectomy: a Pilot Study on Cognitive Functions in Severe Obese Patients

Authors: Xinyang Zhao, Qi Xue, Ling Dong, Zhaoxia Chu, Yong Wang, Chanjuan Chen, Xianwen Hu, Ye Zhang, Chunxia Huang

Published in: Obesity Surgery | Issue 1/2023

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Abstract

Background

In addition to the analgesic effect, peripheral neural blocks also prevent cognitive impairment and peripheral inflammation induced by surgery. However, it is unknown if there is collateral impact on cognitive improvement after bariatric surgery.

Methods

In this pilot study, 75 patients with severe obesity for selective laparoscopic sleeve gastrectomy (LSG) were recruited and randomized into three groups (1:1:1) as general anesthesia (GA) group, transverse abdominis plane block (TAPB) group, and quadratus lumborum block (QLB) group. Bilateral TAPB or QLB was performed (0.33% ropivacaine with dexmedetomidine 1 μg/kg) before the standardized general anesthesia. Cognitive test battery was completed before LSG and in 1-month and 3-month follow-up. The levels of peripheral inflammatory cytokines were determined at equivalent time points.

Results

Patients with LSG exhibited massive cognitive improvement in postoperative 3 month without or with TAPB or QLB (Ptime < 0.001). Compared to GA, QLB significantly strengthened performance in MoCA (β = 0.56, 95%CI: 0.08, 1.05). IL-6, IL-8, and high-sensitivity CRP significantly verified among three groups. Changes in IL-6 within postoperative 3 months were negatively correlated with MMSE and MoCA, and positively correlated with AVLT-DR for QLB group. Similar correlation was found in the GA group for changes in IL-6 and AVLT-IR.

Conclusion

Laparoscopic sleeve gastrectomy ideally improved memory and attention as early as postoperative 1 month. QLB promoted cognitive improvement in MoCA, which was negatively correlated with changes in IL-6. More precise trials are needed to determine the overall effect of peripheral neural block on cognition following bariatric surgery.

Graphical Abstract

Appendix
Available only for authorised users
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Metadata
Title
Effects of Peripheral Neural Blocks in Laparoscopic Sleeve Gastrectomy: a Pilot Study on Cognitive Functions in Severe Obese Patients
Authors
Xinyang Zhao
Qi Xue
Ling Dong
Zhaoxia Chu
Yong Wang
Chanjuan Chen
Xianwen Hu
Ye Zhang
Chunxia Huang
Publication date
05-11-2022
Publisher
Springer US
Published in
Obesity Surgery / Issue 1/2023
Print ISSN: 0960-8923
Electronic ISSN: 1708-0428
DOI
https://doi.org/10.1007/s11695-022-06319-y

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