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

Abstract

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 (T1-4), 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 T3-4 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.

• Authors: Ya-Nan Li, Qi Zhang, Chun-Ping Yin, Yang-Yang Guo, Shu-Ping Huo, Liang Wang, Qiu-Jun Wang
• Journal: Medicine (Medicine (Baltimore)) Vol. 96 Issue 19 Pg. e6849 (May 2017) ISSN: 1536-5964 [Electronic] United States
• PMID: 28489775 (Publication Type: Journal Article, Observational Study, Randomized Controlled Trial)

Chemical References

• Glial Fibrillary Acidic Protein
• Neuroprotective Agents
• S100 Calcium Binding Protein beta Subunit
• S100B protein, human
• Nimodipine
• Oxygen

Topics

• Aged
• Anesthesia, General (adverse effects)
• Blood Gas Analysis
• Cerebrum (metabolism)
• Delirium (drug therapy, epidemiology, etiology, metabolism)
• Enzyme-Linked Immunosorbent Assay
• Female
• Glial Fibrillary Acidic Protein (blood)
• Humans
• Incidence
• Male
• Neuroprotective Agents (therapeutic use)
• Nimodipine (therapeutic use)
• Orthopedic Procedures (adverse effects)
• Oxygen (metabolism)
• Postoperative Complications (drug therapy, epidemiology, metabolism)
• S100 Calcium Binding Protein beta Subunit (blood)
• Spine (surgery)
• Treatment Outcome