Correspondence  |   September 2012
In Reply
Author Affiliations & Notes
  • Yingmin Cai, M.D.
  • *Second Affiliated Hospital, Medical College, Xi'an Jiaotong University, Shaanxi Province, China.
Article Information
Correspondence   |   September 2012
In Reply
Anesthesiology 9 2012, Vol.117, 678. doi:
Anesthesiology 9 2012, Vol.117, 678. doi:
Thank you for your attention and good suggestion regarding our article.1 In clinical practice, we have observed that even if known factors had been excluded, there were still some patients who suffered from postoperative cognitive dysfunction—even to the extent that there is a handful of patients who suffered from long-term postoperative cognitive dysfunction. We hypothesized that there must be some other factors that we did not know about, this is why we designed this clinical trial. Because the incidence of postoperative cognitive dysfunction is low, to analyze the reason for this, a large sample is needed.
Sometimes postoperative cognitive dysfunction that occurred because of anesthesia is reversible, but the cognitive dysfunction resulting from some diseases (such as Alzheimer disease) is not reversible. The essence of the cognitive dysfunction is different, even if the Mini-Mental State Examination score is same.
There is no nitrous oxide in the inhaled anesthesia group.
To focus on the association between postoperative cognitive dysfunction and apolipoprotein E4, some sections of results were deleted during the process of modification.
Apolipoprotein E single nucleotide polymorphism varies among people with different ethnic backgrounds and living in different regions. The current study was conducted in patients who are of Han ethnicity residing in northwest China; thus, inevitable limitation exists in our research findings. The scientific results would be more universal if performed and verified in much more diverse territories and ethnic groups. We hope to see more similar or different results.
Cai Y, Hu H, Liu P, Feng G, Dong W, Yu B, Zhu Y, Song J, Zhao M: Association between the apolipoprotein E4 and postoperative cognitive dysfunction in elderly patients undergoing intravenous anesthesia and inhalational anesthesia. ANESTHESIOLOGY 2012; 116:84–93