title: Selective impairment of attention networks during propofol anesthesia after gynecological surgery in middle-aged women.
abstract: BACKGROUND
  Postoperative cognitive dysfunction is a common complication of anesthesia and surgery. Attention networks are essential components of cognitive function and are subject to impairment after anesthesia and surgery. It is not known whether such impairment represents a global attention deficit or relates to a specific attention network. We used an Attention Network Task (ANT) to examine the efficiency of the alerting, orienting, and executive control attention networks in middle-aged women (40-60 years) undergoing gynecologic surgery. A matched group of medical inpatients were recruited as a control.
  
  
  METHODS
  Fifty female patients undergoing gynecologic surgery (observation group) and 50 female medical inpatients (control group) participated in this study. Preoperatively patients were administered a mini-mental state examination as a screening method. The preoperative efficiencies of three attention networks in an attention network test were compared to the 1st and 5th post-operative days.
  
  
  RESULTS
  The control group did not have any significant attention network impairments. On the 1st postoperative day, significant impairment was shown in the alerting (p=0.003 vs. control group, p=0.015 vs. baseline), orienting (p<0.001 vs. both baseline level and control group), and executive control networks (p=0.007 vs. control group, p=0.002 vs. baseline) of the observation group. By the 5th postoperative day, the alerting network efficiency had recovered to preoperative levels (p=0.464 vs. baseline) and the orienting network efficiency had recovered partially (p=0.031 vs. 1st post-operative day), but not to preoperative levels (p=0.01 vs. baseline). The executive control network did not recover by the 5th postoperative day (p=0.001 vs. baseline, p=0.680 vs. 1st post-operative day).
  
  
  CONCLUSIONS
  Attention networks of middle-aged women show a varying degree of significant impairment and differing levels of recovery after surgery and propofol anesthetic.
authors.affiliation: Department of Anesthesiology, First Affiliated Hospital, Anhui Medical University, 218 Jixi Road, Hefei, Anhui 230022, China.
authors.forename: Chen
authors.initials: C
authors.lastname: Chen
authors.affiliation: Department of Anesthesiology, First Affiliated Hospital, Anhui Medical University, 218 Jixi Road, Hefei, Anhui 230022, China.
authors.forename: Guang-hong
authors.initials: GH
authors.lastname: Xu
authors.affiliation: Department of Anesthesiology, First Affiliated Hospital, Anhui Medical University, 218 Jixi Road, Hefei, Anhui 230022, China. Electronic address: ahjxxgh@sina.com.
authors.forename: Yuan-hai
authors.initials: YH
authors.lastname: Li
authors.affiliation: Department of Anesthesiology, First Affiliated Hospital, Anhui Medical University, 218 Jixi Road, Hefei, Anhui 230022, China.
authors.forename: Wei-xiang
authors.initials: WX
authors.lastname: Tang
authors.affiliation: Department of Neurology, First Affiliated Hospital, Anhui Medical University, 218 Jixi Road, Hefei, Anhui 230022, China.
authors.forename: Kai
authors.initials: K
authors.lastname: Wang
mesh_terms: D000328:Adult; D000771:Anesthesia, Intravenous / Q000009:adverse effects*; D001288:Attention / Q000187:drug effects* / Q000502:physiology; D003071:Cognition / Q000187:drug effects / Q000502:physiology; D003072:Cognition Disorders / Q000139:chemically induced* / Q000175:diagnosis / Q000523:psychology; D056344:Executive Function / Q000187:drug effects / Q000502:physiology; D005260:Female; D013509:Gynecologic Surgical Procedures / Q000009:adverse effects*; D006801:Humans; D008875:Middle Aged; D009415:Nerve Net / Q000187:drug effects* / Q000502:physiology; D010775:Photic Stimulation / Q000379:methods; D011183:Postoperative Complications / Q000139:chemically induced / Q000175:diagnosis / Q000523:psychology; D015742:Propofol / Q000009:adverse effects*; D011930:Reaction Time / Q000187:drug effects / Q000502:physiology
chemical_list: D015742:Propofol
keywords: Attention network impairment; Attention network test; Gynecologic surgery; Middle-aged women; Post-operative cognitive dysfunction; Propofol