Cargando…

Effects of nimodipine on postoperative delirium in elderly under general anesthesia: A prospective, randomized, controlled clinical trial

Nimodipine is a clinical commonly used calcium antagonistscan lowering the apoptosis rate of hippocampal neuron to reduce the incidence of postoperative cognitive dysfunction (POCD). This study was designed to evaluate the effects of nimodipine on postoperative delirium in elderly under general anes...

Descripción completa

Detalles Bibliográficos
Autores principales: Li, Ya-Nan, Zhang, Qi, Yin, Chun-Ping, Guo, Yang-Yang, Huo, Shu-Ping, Wang, Liang, Wang, Qiu-Jun
Formato: Online Artículo Texto
Lenguaje:English
Publicado: Wolters Kluwer Health 2017
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5428609/
https://www.ncbi.nlm.nih.gov/pubmed/28489775
http://dx.doi.org/10.1097/MD.0000000000006849
_version_ 1783235858916179968
author Li, Ya-Nan
Zhang, Qi
Yin, Chun-Ping
Guo, Yang-Yang
Huo, Shu-Ping
Wang, Liang
Wang, Qiu-Jun
author_facet Li, Ya-Nan
Zhang, Qi
Yin, Chun-Ping
Guo, Yang-Yang
Huo, Shu-Ping
Wang, Liang
Wang, Qiu-Jun
author_sort Li, Ya-Nan
collection PubMed
description Nimodipine is a clinical commonly used calcium antagonistscan lowering the apoptosis rate of hippocampal neuron to reduce the incidence of postoperative cognitive dysfunction (POCD). This study was designed to evaluate the effects of nimodipine on postoperative delirium in elderly under general anesthesia. Sixty patients shceduced spine surgery under general anesthesia were randomly assigned into 2 groups using a random number table: control group (Group C) and nimodipine group (Group N). In Group N, nimodipine 7.5 μg/(kg × h) was injected continually 30 minutes before anesthesia induction, while the equal volume of normal saline was given in Group C. At 0 minute before injection, 0 minute after tracheal intubation, 1 hour after skin incision and surgery completed (T(1–4)), blood samples were taken from the radial artery and jugular bulb for blood gas analysis. Cerebral oxygen metabolism-related indicators were calculated at the same time. Concentration of S100β and glial fibrillary acidic protein (GFAP) were tested by ELISA. The incidence of postoperative delirium within 7 days after surgery was recorded. Cerebral oxygen metabolism-related indicators fluctuationed in the normal range in 2 groups at different time points and the difference were not statistically significant. Compared with Group C, S100β and GFAP decreased and incidence of postoperative delirium reduced at T(3–4) in Group N, the difference was statistically significant (P<.05). The present study suggests that nimodipine can reduce the development of postoperative delirium in elderly patients under general anesthesia, the reduction of brain injury and improvement of cerebral oxygen metabolism may be involved in the mechanism.
format Online
Article
Text
id pubmed-5428609
institution National Center for Biotechnology Information
language English
publishDate 2017
publisher Wolters Kluwer Health
record_format MEDLINE/PubMed
spelling pubmed-54286092017-05-17 Effects of nimodipine on postoperative delirium in elderly under general anesthesia: A prospective, randomized, controlled clinical trial Li, Ya-Nan Zhang, Qi Yin, Chun-Ping Guo, Yang-Yang Huo, Shu-Ping Wang, Liang Wang, Qiu-Jun Medicine (Baltimore) 3300 Nimodipine is a clinical commonly used calcium antagonistscan lowering the apoptosis rate of hippocampal neuron to reduce the incidence of postoperative cognitive dysfunction (POCD). This study was designed to evaluate the effects of nimodipine on postoperative delirium in elderly under general anesthesia. Sixty patients shceduced spine surgery under general anesthesia were randomly assigned into 2 groups using a random number table: control group (Group C) and nimodipine group (Group N). In Group N, nimodipine 7.5 μg/(kg × h) was injected continually 30 minutes before anesthesia induction, while the equal volume of normal saline was given in Group C. At 0 minute before injection, 0 minute after tracheal intubation, 1 hour after skin incision and surgery completed (T(1–4)), blood samples were taken from the radial artery and jugular bulb for blood gas analysis. Cerebral oxygen metabolism-related indicators were calculated at the same time. Concentration of S100β and glial fibrillary acidic protein (GFAP) were tested by ELISA. The incidence of postoperative delirium within 7 days after surgery was recorded. Cerebral oxygen metabolism-related indicators fluctuationed in the normal range in 2 groups at different time points and the difference were not statistically significant. Compared with Group C, S100β and GFAP decreased and incidence of postoperative delirium reduced at T(3–4) in Group N, the difference was statistically significant (P<.05). The present study suggests that nimodipine can reduce the development of postoperative delirium in elderly patients under general anesthesia, the reduction of brain injury and improvement of cerebral oxygen metabolism may be involved in the mechanism. Wolters Kluwer Health 2017-05-12 /pmc/articles/PMC5428609/ /pubmed/28489775 http://dx.doi.org/10.1097/MD.0000000000006849 Text en Copyright © 2017 the Author(s). Published by Wolters Kluwer Health, Inc. http://creativecommons.org/licenses/by/4.0 This is an open access article distributed under the Creative Commons Attribution License 4.0 (CCBY), which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited. http://creativecommons.org/licenses/by/4.0
spellingShingle 3300
Li, Ya-Nan
Zhang, Qi
Yin, Chun-Ping
Guo, Yang-Yang
Huo, Shu-Ping
Wang, Liang
Wang, Qiu-Jun
Effects of nimodipine on postoperative delirium in elderly under general anesthesia: A prospective, randomized, controlled clinical trial
title Effects of nimodipine on postoperative delirium in elderly under general anesthesia: A prospective, randomized, controlled clinical trial
title_full Effects of nimodipine on postoperative delirium in elderly under general anesthesia: A prospective, randomized, controlled clinical trial
title_fullStr Effects of nimodipine on postoperative delirium in elderly under general anesthesia: A prospective, randomized, controlled clinical trial
title_full_unstemmed Effects of nimodipine on postoperative delirium in elderly under general anesthesia: A prospective, randomized, controlled clinical trial
title_short Effects of nimodipine on postoperative delirium in elderly under general anesthesia: A prospective, randomized, controlled clinical trial
title_sort effects of nimodipine on postoperative delirium in elderly under general anesthesia: a prospective, randomized, controlled clinical trial
topic 3300
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5428609/
https://www.ncbi.nlm.nih.gov/pubmed/28489775
http://dx.doi.org/10.1097/MD.0000000000006849
work_keys_str_mv AT liyanan effectsofnimodipineonpostoperativedeliriuminelderlyundergeneralanesthesiaaprospectiverandomizedcontrolledclinicaltrial
AT zhangqi effectsofnimodipineonpostoperativedeliriuminelderlyundergeneralanesthesiaaprospectiverandomizedcontrolledclinicaltrial
AT yinchunping effectsofnimodipineonpostoperativedeliriuminelderlyundergeneralanesthesiaaprospectiverandomizedcontrolledclinicaltrial
AT guoyangyang effectsofnimodipineonpostoperativedeliriuminelderlyundergeneralanesthesiaaprospectiverandomizedcontrolledclinicaltrial
AT huoshuping effectsofnimodipineonpostoperativedeliriuminelderlyundergeneralanesthesiaaprospectiverandomizedcontrolledclinicaltrial
AT wangliang effectsofnimodipineonpostoperativedeliriuminelderlyundergeneralanesthesiaaprospectiverandomizedcontrolledclinicaltrial
AT wangqiujun effectsofnimodipineonpostoperativedeliriuminelderlyundergeneralanesthesiaaprospectiverandomizedcontrolledclinicaltrial