Effects of Limb Remote Ischemic Preconditioning for Prevention of Delirium in Elderly Patients After Non-cardiac Surgery

Study Overview
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Brief Summary
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To investigate whether limb remote ischemic preconditioning (LRIP) could safely decrease the incidence of delirium in elderly patients after non-cardiac surgery.

Detailed Description
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Remote ischaemic preconditioning may confer the cytoprotection in critical organs. We hypothesized that limb remote ischemic preconditioning (RIPC) would safely decrease the incidence of delirium in elderly patients after non-cardiac surgery.The primary outcomes included the incidence of delirium in the first 7 days after surgery using the Confusion Assessment Method for the Intensive Care Unit (CAM-ICU) scale.The quality of recovery over a 6-month period was evaluated as well.Secondary endpoints included length of stay in the hospital after surgery (from day of surgery to hospital discharge), occurrence of non-delirium postoperative complications, and all-cause 6-month mortality.

Official Title
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Effects of Limb Remote Ischemic Preconditioning for Prevention of Delirium in Elderly Patients After Non-cardiac Surgery:a Randomised, Double-blind, Placebo-controlled Trial

Conditions
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Elderly Patients, Non-cardiac Surgery

Intervention / Treatment
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* Procedure: limb remote ischemic preconditioning(LRIP)


Participation Criteria
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Eligibility Criteria
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Inclusion Criteria: elderly patients received elective non-cardiac surgery with general anesthesia anticipated surgery time > 2 hours Exclusion Criteria: age < 65 years old Acute coronary syndrome or myocardial infraction within 3 months Chronic obstructive pulmonary emphysema Serious hepatic dysfunction (Child-Pugh class C) serious renal dysfunction (undergoing dialysis before surgery) Ejection fraction less than 40% Poor pulmonary function (PaO2 <60mmHg) Preoperative history of schizophrenia, epilepsy, Parkinsonism, or myasthenia gravis Inability to communicate in the preoperative period (coma, profound dementia, or language barrier) Brain injury or neurosurgery

Ages Eligible for Study
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Minimum Age: 65 Years

Sexes Eligible for Study
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All

Accepts Healthy Volunteers
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No

Study Plan
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How is the study designed?
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Design Details

Primary Purpose: Prevention
Allocation: Randomized
Intervention Model: Parallel Assignment
Masking: Triple


Arms and Interventions

| Participant Group/Arm | Intervention/Treatment |
| --- | --- |
| Experimental: Limb RIPC<br>The limb RIPC protocol was applied after anesthetic induction and before the start of surgery. The limb RIPC was induced by placing a blood pressure cuff on the left upper arm of patient for three inflating-deflating cycles: 5 min inflating to 200 mmHg followed by a 5 min reperfusion with deflating the cuff. | Procedure: limb remote ischemic preconditioning(LRIP)<br>* LRIP consisted of three cycles of left upper limb ischemia induced by inflating a blood pressure cuff on the left upper arm to 200mmHg, with an intervening 5 minutes of reperfusion, during which time the cuff was deflated.<br>* Other names: LRIP;|
| No Intervention: Convention<br>Elderly patients undergoing non-cardiac surgery received no treatment after induction of anaesthesia | |

What is the study measuring?
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Primary Outcome Measures

| Outcome Measure | Measure Description | Time Frame |
| --- | --- | --- |
| the incidence of delirium |  | in the first 7 days after surgery | 

 Terms related to the study
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Keywords Provided by Centre Hospitalier Valida
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elderly patients, non-cardiac surgery, ischemic preconditioning, delirium