The Effect of Central Sensitization on Postoperative Neurocognitive Dysfunction in Hospitalized Elderly Patients: A Prospective Cohort Clinical Trial

ABSTRACT

Objective

To investigate whether central sensitization (CS) in elderly patients was a predictive risk factor for postoperative neurocognitive dysfunction (PNCD).

Methods

One hundred and thirty-three aged patients undergoing total knee arthroplasty (TKA) who received femoral nerve block and general anesthesia were recruited in this research and prospectively assigned into two groups according to the Central Sensitization Inventory (CSI) score: group C (n = 106, CSI score less than 40) and group CS (n = 27, CSI score higher than 40). Scores of Montreal Cognitive Assessment (MoCA), Mini-Mental State Examination (MMSE), Confusion Assessment Method (CAM), Numerical Rating Scale (NRS) and Quality of recovery-40 (QoR-40) questionnaires were assessed. Basic information and clinical records of all participants were also collected.

Results

PNCD occurred in 24 (22.6%) of patients in group C and 16 (59.3%) in group CS (p < .05). Multivariate logistic regression analysis revealed that patients with CSI score ≥40 before surgery exhibited higher risk of PNCD after adjustment for other risk factors (p < .05). Compared to group C, the pre- and post-operative NRS scores, pain duration, the WOMAC score, and propofol consumptions for anesthesia induction were significantly increased in group CS (p < .05).

Conclusion

Hospitalized elderly patients with clinical symptoms of CS scores may have increased risk of PNCD following TKA.

Acknowledgments

Hebei Province technology innovation guide Project Science and Technology Winter Olympics special project (19977790D); Hebei Provincial government funded the specialty capacity and specialty leader training program (361005).

Disclosure statement

No potential conflict of interest was reported by the author(s).

Data availability statement

All data generated or analyzed during this study are included in the manuscript.

Ethical Approval

This research received ethical approval by the Medical Science Research Ethics Committees of the Third Hospital of Hebei Medical University (Ethical Registration Number: 2020-044-1) and was conducted following guidelines in the Helsinki Declaration. All participants received written and informed consents prior to enrollment into this study. The trial was registered at Chinese Clinical Trial Registry (register number: ChiCTR2100044041).

Additional information

Funding

The work was supported by the Hebei Provincial government funded the specialty capacity and specialty leader training program [361005]; Hebei Province technology innovation guide Project Science and Technology Winter Olympics special project [19977790D].