ArticleJournal of anaesthesiology, clinical pharmacology
Association of cholinergic biomarkers with postoperative delirium in elderly patients undergoing regional anesthesia - An observational study.
Article in Journal of anaesthesiology, clinical pharmacology. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 1 paper.
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The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
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Who cites it
1 citing paper in PubMed.
- The perioperative brain-heart-immune axis: autonomic resilience, multimodal monitoring and postoperative delirium.Frontiers in medicine · 2026Review
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Authors and funding
8 authors.
Funding
No grant is acknowledged in the PubMed record.
Abstract
Background and Aims: Postoperative delirium (POD) is a prevalent and serious complication in elderly patients undergoing surgery, contributing to prolonged hospital stays and increased morbidity. While the exact mechanism remains elusive, growing evidence suggests the involvement of the cholinergic system in delirium pathogenesis. Material and Methods: This observational study aimed to investigate the association between cholinergic biomarkers and POD in elderly patients under regional anesthesia. Eighty-seven patients scheduled for surgery under regional anesthesia were enrolled. Baseline cognitive function was assessed using the Mini-Mental State Examination preoperatively. POD assessment was conducted in the postoperative care unit on days 1, 2, 3, and 7 by using the Confusion Assessment Method. Severity of delirium was evaluated using the Memorial Delirium Assessment Scale. Plasma levels of choline acetyltransferase (ChAT), acetylcholinesterase (AChE), and butyrylcholinesterase (BuChE) were measured preoperatively and 24 hours postoperatively. Results: Fourteen patients were diagnosed with POD. Compared to the non-POD group, the POD group exhibited significantly higher levels of ChAT and lower levels of AChE and BuChE both pre- and postoperatively ( Conclusions: This study concludes that alterations in postoperative activity of AChE, BuChE, and ChAT are associated with the development of POD in elderly patients undergoing surgery under regional anesthesia. BuChE activity showed the greatest diagnostic value among the cholinergic biomarkers assessed. These findings underscore the potential importance of cholinergic dysfunction in POD pathogenesis and highlight the diagnostic utility of assessing cholinergic biomarkers in predicting POD risk.
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