Effects of remote ischemic preconditioning on occurrence of postoperative delirium in elderly patients undergoing radical mastectomy
10.3760/cma.j.issn.0254-1416.2019.09.007
- VernacularTitle: 肢体远隔缺血预处理对肺癌根治术老年患者术后谵妄发生的影响
- Author:
Xiaole LIU
1
;
Rui MENG
;
Fang FANG
;
Junhui ZHOU
;
Xianhui MENG
Author Information
1. Department of Anesthesiology, Henan Provincial Chest Hospital, Zhengzhou 450008, China
- Publication Type:Journal Article
- Keywords:
Ischemic Preconditioning;
Lung neoplasms;
Aged;
Delirium
- From:
Chinese Journal of Anesthesiology
2019;39(9):1051-1054
- CountryChina
- Language:Chinese
-
Abstract:
Objective:To evaluate the effects of remote ischemic preconditioning (RIPC) on occurrence of postoperative delirium in elderly patients undergoing radical mastectomy.
Methods:Sixty elderly patients, aged 65-78 yr, of American Society of Anesthesiologists physical status Ⅱ or Ⅲ, scheduled for elective radical mastectomy, were allocated into 2 groups (n=30 each) using a random number table method: control group (group C) and RIPC group.Three cycles of 5-min ischemia/5-min reperfusion induced by a blood pressure cuff placed on the upper arm of the right upper arm served as RIPC treatment at 5 min after induction of anesthesia in RIPC group.The blood pressure cuff was only placed on the upper arm of the right upper arm without inflation and deflation in group C. Jugular bulb venous blood samples were obtained at 10 min before anesthesia induction (T0) and 1, 12, 24, 48 and 72 h after the end of operation (T1-5) for determination of S-100β protein and neuron-specific enolase (NSE) concentrations in serum.The occurrence of delirium within 72 h after operation was estimated using Confusion Assessment Method for the Intensive Care Unit.The occurrence of hypotension, sinus bradycardia and reintubation was recorded.The Quality of Recovery-15 (QoR-15) was used to evaluate the early postoperative quality of recovery at 1 and 2 days after operation.
Results:Compared with group C, the concentrations of S-100β protein and NSE in serum and incidence of delirium within 72 h after operation were significantly decreased at T1-T5, and the Quality of Recovery-15 scores were increased at 1 and 2 days after operation in group RIPC (P<0.05). There was no significant difference in the duration of delirium or incidence of hypotension, sinus bradycardia and reintubation between the two groups (P>0.05).
Conclusion:RIPC can decrease the development of postoperative delirium and is helpful for the early postoperative recovery of elderly patients undergoing radical mastectomy.
