Comparison of hemostatic effect and safety between epinephrine and tramazoline during nasotracheal intubation: a double-blind randomized trial

Abstract Background Nasal bleeding is the most common complication during nasotracheal intubation (NTI). To reduce nasal bleeding, the nasal mucosa is treated with vasoconstrictors (epinephrine [E] or tramazoline [T]) prior to NTI. This study aimed to determine whether E or T is more effective and safe for reducing nasal bleeding during NTI. Methods This study was preregistered on UMIN-CTR after being approved by the IRB of the School of Dentistry at Aichi Gakuin University. Written consent was received from all the patients. Total 206 patients aged 20–70 years and classified as 1–2 on American Society of Anesthesiologists-physical status were scheduled to undergo general anesthesia with NTI. At last, 197 patients were randomly divided into two groups and treated with either E (n = 99; 3 patients were discontinued) or T (n = 98; 2 patient were discontinued). After induction of general anesthesia, each patient’s nasal mucosa was treated using either E or T. The E used in this study was BOSMIN® SOLUTION 0.1% (Daiichi-Sankyo Co., Ltd., Tokyo), and the T used in this study was TRAMAZOLIN Nasal Solution 0.118% AFP, (Alfresa Pharma Corporation, Osaka). E was diluted five times according to the package insert (final concentration of E = 0.02%), and T was used in its original solution. After 2 min, NTI was performed via the right nostril. Primary outcome were the presence of nasal bleeding (if bleeding was recognized at the posterior pharyngeal wall via nasal cavity during intubation, it was defined as bleeding) and the degree of bleeding (classified as none, mild, moderate, or severe). Secondary outcomes were arrhythmia, and hemodynamic (mean atrial pressure and heart rate) changes associated with vasoconstrictors. Results The presence of bleeding was comparable in both groups (12.5%, E; 14.5%, T; P = 0.63). No significant difference between the groups regarding the degree of bleeding (P = 0.78) was observed, with most patients having no bleeding (n = 84, E; n = 82, T). No severe bleeding and no arrhythmias induced by vasoconstrictor were observed in the two groups. Conclusions Nasal treatment with E or T shows no difference in nasal bleeding during NTI. Although no arrhythmia associated with E was observed in this study, it has been reported in literature. Therefore, as frequency and degree of nasal bleeding were comparable, nasal treatment with T could reduce the risk of NTI. Trial registration UMIN-CTR (Registration No. UMIN000037907). Registered (05/09/2019).

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Epinephrine versus tramazoline to reduce nasal bleeding during nasotracheal intubation. A double-blind randomized trial

10.21203/rs.3.rs-148779/v1 ◽

2021 ◽

Author(s):

Aiji Sato(Boku) ◽

Yoshiki Sento ◽

Yuji Kamimura ◽

Eisuke Kako ◽

Masahiro Okuda ◽

...

Keyword(s):

General Anesthesia ◽

Nasal Cavity ◽

Nasotracheal Intubation ◽

Severe Bleeding ◽

Double Blind ◽

Pharyngeal Wall ◽

Severe Arrhythmia ◽

Significant Difference ◽

Nasal Bleeding ◽

School Of Dentistry

Abstract BACKGROUNDː Nasal bleeding is the most common complication during nasotracheal intubation (NTI). To reduce nasal bleeding, the nasal cavity is treated with vasoconstrictors (epinephrine [E] or tramazoline [T]) prior to NTI. This study aimed to determine whether E or T is more effective and safe for reducing nasal bleeding during NTI.METHODSː This study was preregistered on UMIN-CTR after being approved by the IRB of the School of Dentistry at Aichi Gakuin University. Written consent was received from all the patients. Total 206 patients aged 20–70 years and classified as 1–2 on American Society of Anesthesiologists-physical status were scheduled to undergo general anesthesia with NTI. Patients with a narrowed nasal cavity observed during preoperative CT test (n = 3), patients with hypertension (n = 3), patients undergoing antithrombotic therapy, and patients who did not give consent (n = 3) were excluded from the study. At last, 197 patients were randomly divided into two groups and treated with either E (n = 99; 3 patients were discontinued) or T (n = 98; 2 patient were discontinued). After induction of general anesthesia, each patient’s nasal cavity was treated using either E or T. Next, NTI was performed via the right nostril. Primary outcome was the presence of nasal bleeding. If bleeding was recognized at the posterior pharyngeal wall via nasal cavity during intubation, it was defined as bleeding. Secondary outcomes were the degree of bleeding (classified as none, mild, moderate, or severe), arrhythmia, and hemodynamic (mean atrial pressure and heart rate) changes associated with vasoconstrictors.RESULTSː The presence of bleeding was comparable in both groups (12.5%, E; 14.5%, T; P = 0.63). No significant difference between the groups regarding the degree of bleeding (P = 0.78) was observed, with most patients having no bleeding (n = 84, E; n = 82, T).No severe bleeding and no arrhythmias induced by vasoconstrictor were observed in the two groups.CONCLUSIONSː Nasal treatment with E or T shows no difference in nasal bleeding during NTI. Although no arrhythmia associated with E was observed in this study, it has been reported in literature. Therefore, as frequency and degree of nasal bleeding were comparable, nasal treatment with T could reduce the risk of NTI.Trial RegistrationUMIN-CTR (Registration No. UMIN000037907)

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Evaluating the effect of calcium chloride in combination with neostagmine and atropine against residual neuromuscular blockade at the end of general anesthesia

QJM ◽

10.1093/qjmed/hcaa039.016 ◽

2020 ◽

Vol 113 (Supplement_1) ◽

Author(s):

M M Marzouk ◽

R A Shoukry ◽

S A Refaat ◽

A M Fathi

Keyword(s):

General Anesthesia ◽

Endotracheal Tube ◽

Calcium Chloride ◽

Neuromuscular Blockade ◽

P Value ◽

Double Blind ◽

Residual Neuromuscular Blockade ◽

Significant Difference ◽

Group A ◽

Group B

Abstract Background Muscle relaxants used in general anesthesia during the insertion of an endotracheal tube (ETT) to relax the muscles of the neck and throat, which reduces the risk of injury. They also are used to relax the chest muscles when an endotracheal tube is used to aid mechanical ventilation. Objective The aim of this study has been to evaluate the effect of calcium chloride coadministered with neostigmine and atropine on neuromuscular blockade recovery time at the end of general anesthesia. And compare it’s effect against usual neuromuscular reverse of neostigmine and atropine. Patients and Methods In this present study we use Double blind prospective randomized Clinical trial study, 30 patients were enrolled. They were divided in two groups each of which contains 15 patients: Group (A): received 5 mg/kg of calcium chloride coadministered with 25 μg/kg of neostigmine and 15 μg/kg of atropine at the end of surgery. Group (B): received the same volume of normal saline coadministered with 25 μg kg of neostigmine and 15 μg / kg of atropine at the end of surgery. Results Comparison between calcium and neostigmine groups according TOF at 5 minutes and 10 minutes using Independent t-test, P- value was less than 0.01 which means that there is high significant difference between 2 groups. On the other hand, TOF at 20 minutes in calcium and neostigmine groups shows no difference at all. Conclusion So Calcium chloride elevate serum calcium level, calcium has antineuromuscular blockade effect, therefore calcium chloride increase TOF and enhance neuromuscular recovery and decrease the PORC after neostigmine administration.

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Intra Operative Use of Anti Emetic Drugs for Children Undergoing Full Dental Rehabilitation under General Anesthesia. A Double Blind Randomized Clinical Trial

Journal of Clinical Pediatric Dentistry ◽

10.17796/1053-4628-40.3.235 ◽

2016 ◽

Vol 40 (3) ◽

pp. 235-240 ◽

Cited By ~ 1

Author(s):

Hisham Y El Batawi ◽

Ahmed A Shorrab

Keyword(s):

Clinical Trial ◽

General Anesthesia ◽

Dental Treatment ◽

Postoperative Nausea And Vomiting ◽

Control Group ◽

Double Blind ◽

Dental Procedures ◽

Dental Staff ◽

Significant Difference ◽

Dental Rehabilitation

Background: Postoperative Nausea and Vomiting (PONV) is a common complication following dental treatment under general anesthesia (DGA) that may lead to unplanned hospitalization, increased costs and dissatisfaction of parents. Aim: To investigate the incidence of Postoperative Vomiting (POV) on children who underwent dental rehabilitation under general anesthesia and to compare possible preventive effect of Dexamethasone and Ondansetron on occurrences of POV. Study design: A double blind randomized parallel clinical trial was carried out on 352 ASA I children who underwent DGA in a private Saudi hospital in Jeddah. Children were allocated randomly to four groups. Group D of 91 children, received Dexamethasone PONV prophylaxis, group O of 87 children received Ondansetron, group DO of 93 children received combination of the two drugs and group C the control group of 81 children. The three groups were investigated by blinded dental staff for POV episodes, number of times analgesia was needed and post anesthesia care unit time (PACUT). Results: There was a no significant difference between the two drugs on POV. There was a significant difference in POV between control group and groups D, O, and DO. There was significant reduction in need for analgesia in the Dexamethasone groups. The three groups, which had PONV prophylaxis, showed significant reduction in PACUT compared to control group. Conclusions: Antiemetic drugs are useful adjuncts in DGA. Some dental procedures may have higher emetic potential than others. The type of dental procedures done is to be considered when deciding the drug profile in children undergoing DGA.

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Pilot Study Comparing Nasal vs Oral Intubation for Dental Surgery by Physicians, Nurse Anesthetists, and Trainees

Anesthesia Progress ◽

10.2344/anpr-65-02-07 ◽

2018 ◽

Vol 65 (2) ◽

pp. 89-93 ◽

Cited By ~ 1

Author(s):

J. Patrick Bowman ◽

Michael P. Nedley ◽

Kimberly A. Jenkins ◽

Charles R. Fahncke

Keyword(s):

General Anesthesia ◽

Dental Treatment ◽

Nasotracheal Intubation ◽

Orotracheal Intubation ◽

Nurse Anesthetists ◽

Radiographic Imaging ◽

Dental Surgery ◽

Physical Status Classification ◽

Medicine Physician ◽

Significant Difference

The purpose of this article was to determine if pediatric dental treatment under general anesthesia utilizing orotracheal intubation takes longer than using nasotracheal intubation techniques. Twenty-six American Society of Anesthesiologists Physical Status Classification I and II pediatric dental patients, ages 2–8 years treated under general anesthesia, were assigned to 1 of 2 groups: (a) nasotracheal intubation (control, n = 13), (b) orotracheal intubation (experimental, n = 13). Times for intubation, radiographic imaging, and dental procedures, as well as total case time were quantified. Data were collected on airway difficulty, numbers of providers needed for intubation, intubation attempts, and intubation trauma. There was a significant difference in mean intubation time (oral = 2.1 minutes versus nasal = 6.3 minutes; p < .01). There was no difference in mean radiograph time (oral = 4.2 minutes versus nasal = 3.4 minutes; p = .144), and overall radiograph image quality was not affected. There was no difference in dental procedure time (p = .603) or total case time (p = .695). Additional providers were needed for intubation and more attempts were required for nasotracheal intubation versus orotracheal intubation (6 additional providers/22 attempts vs 0 additional providers/15 attempts, p < .01 and p < .05, respectively). Nine of 13 nasotracheal intubations were rated as traumatic (69%) versus 0 of 13 for orotracheal intubations (0%) (p < .01). In 7/9 orotracheal intubation cases (78%), the tube was not moved during treatment (p < .01). Orotracheal intubation does not increase case time, does not interfere with radiographic imaging, and is less traumatic for the patient when performed by physician anesthesiologists, emergency and pediatric medicine physician residents, certified registered nurse anesthetists, and student nurse anesthetists, all with variable nasotracheal intubation experience.

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Oxycodone 5 Miligram is More Effective Than Ketorolac 30 Miligram in Suppressing Cortisol Levels During General Anesthesia

Journal of Anesthesiology and Clinical Research ◽

10.37275/jacr.v2i1.145 ◽

2021 ◽

Vol 2 (1) ◽

pp. 148-158

Author(s):

Kelvin ◽

Rizal Zainal ◽

Irwanto FH ◽

Erial Bahar

Keyword(s):

General Anesthesia ◽

Sample Size ◽

Intravenous Administration ◽

Elective Surgery ◽

Controlled Trial ◽

Post Intervention ◽

Chi Square ◽

Double Blind ◽

Significant Difference ◽

Cortisol Levels

Background: Preemptive analgesia is a developing clinical concept, which involves administering analgesics before pain stimulation occurs, to prevent the sensitization of the nervous system to further stimuli that can cause pain. Ketorolac has strong analgesic properties oxycodone is a semisynthetic opioid that is synthesized from the alkaloid thebaine opiate. Pain could induce stress hormone such as cortisol. Study to compare ketorolac and oxycodone with cortisol has not been investigated. This study aimed to assess intravenous administration of ketorolac 30 mg compared with intravenous 5 mg oxycodone for pain as measured by cortisol levels post-intervention in surgery performed under general anesthesia. Method: A study randomized controlled trial in double-blind form for patients at dr. Mohammad Hoesin Palembang, who will undergo elective surgery with general anesthesia at the Central Surgical Installation building, with the period September-October 2020. There are 24 study samples, to anticipate dropouts, an added sample size is 10%, so the sample size is 26 for each treatment group. The selection of subjects according to the purpose of the study was carried out by simple random. Data analysis using SPSS ver 22.0 software. Data were analyzed using Independent T-Test, Mann Whitney, and Chi-Square Test. Result: The results showed, there was a significant difference in the effectiveness of intravenous administration of ketorolac 30 mg and intravenous oxycodone 5 mg on pain as measured by cortisol levels in patients undergoing general anesthesia at dr. Mohammad Hoesin Palembang (p = 0.013). The value of cortisol levels in pre- operative patients who will be given general anesthesia at dr. There was no statistically significant difference between Mohammad Hoesin in the two groups (p = 0.107). The value of cortisol levels in preoperative patients who were given ketorolac 30 mg intravenously at dr. Mohammad Hoesin was 9.90 ± 4.2. The value of cortisol levels in postoperative patients who were given ketorolac 30 mg intravenously at dr. Mohammad Hoesin was 17.75 ± 6.08. The value of preoperative cortisol levels for patients who were given oxycodone 5 mg intravenously at dr. Mohammad Hoesin was 12.03 ± 5.10. The value of postoperative cortisol levels for patients who were given oxycodone 5 mg intravenously at dr. Mohammad Hoesin is 14.50 ± 4.75. Conclusion: There was a significant difference in the effectiveness of intravenous administration of ketorolac 30 mg and oxycodone 5 mg intravenously on BSS levels (p = 0.005) and VAS scores (p = 0.001) who underwent general anesthesia at dr. Mohammad Hoesin Palembang.

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A comparison between the Disposcope endoscope and fiberoptic bronchoscope for nasotracheal intubation-A randomized controlled trial

10.21203/rs.2.10697/v1 ◽

2019 ◽

Author(s):

Junma Yu ◽

Rui Hu ◽

Lining Wu ◽

Peng Sun ◽

Zhi Zhang

Keyword(s):

Adverse Reactions ◽

Controlled Trial ◽

Nasotracheal Intubation ◽

Fiberoptic Bronchoscopy ◽

Randomized Controlled ◽

Significant Difference ◽

Severe Epistaxis ◽

Nasal Bleeding ◽

Severe Adverse Reactions ◽

Time Point

Abstract Background Nasotracheal intubation (NTI) is frequently performed in oral and maxillofacial surgeries. This study evaluated whether NTI is easier when guided by Disposcope endoscopy or fiberoptic bronchoscopy. Methods Sixty patients (30 per group) requiring NTI were randomly assigned to undergo fiberoptic bronchoscopy-guided (fibreoptic group) or Disposcope endoscope-guided (Disposcope group) NTI. Then, the NTI time were recorded. Epistaxis was recorded using direct laryngoscopy ﬁve minutes after completing NTI. Results The time to complete NTI was significantly longer in the fiberoptic group than the Disposcope group (38.4 sec vs 24.1 sec; mean difference, 14.2 sec; 95% CI, 10.4 to 18.1). In addition, Mild epistaxis (nasal bleeding) was observed in 8 patients in the fiberoptic group and 7 patients in the Disposcope group (26.7% vs 23.3%, respectively; relative risk, 1.2; 95% CI, 0.4 to 3.9). No moderate or severe epistaxis occurred in either group. Furthermore, there was no obvious nasal pain at any time point after extubation in the Disposcope group, and there was no significant difference between the two groups. Conclusion NTI can be completed successfully using either fiberoptic bronchoscopy or a Disposcope endoscope as a guide without any severe adverse reactions. However, compared to fiberoptic bronchoscopy, the Disposcope endoscope requires less transaction time.

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Comparison of Hemodynamic Changes Due to Endotracheal Intubation With Labetalol and Remifentanil in Severe Preeclamptic Patients Undergoing Cesarean Delivery With General Anesthesia

International Journal of Women s Health and Reproduction Sciences ◽

10.15296/ijwhr.2019.85 ◽

2018 ◽

Vol 7 (4) ◽

pp. 515-519 ◽

Cited By ~ 1

Author(s):

Susan Rasooli ◽

Farnaz Moslemi ◽

Reyhaneh Ari ◽

Hale Vazife Shenas ◽

Majid Shokoohi

Keyword(s):

General Anesthesia ◽

Cesarean Delivery ◽

Severe Preeclampsia ◽

Double Blind Study ◽

Double Blind ◽

Apgar Scores ◽

Mortality And Morbidity ◽

Hemodynamic Variables ◽

Increased Risk ◽

Significant Difference

Objectives: Stress replication to laryngoscopy and intubation are exaggerated in the patient with severe preeclampsia and this stress can lead to an increased risk of maternal mortality and morbidity. The aim of this study was to compare the efficacies of remifentanil and labetalol in attenuating these responses in women with violent preeclampsia undergoing cesarean section (C-section) with general anesthesia. Methods: In this double-blind study, 70 women with violent preeclampsia undergoing cesarean delivery were randomly assigned to two groups to receive either remifentanil 1 µg/kg or labetalol 0.25 mg/kg before the induction of anesthesia. Then, blood pressure (BP) and heart rate (HR) were measured before and 1, 3, and 5 minutes after the intubation. The first and 5th-minute Apgar scores were evaluated as well. Results: All hemodynamic variables decreased in both groups after the administration of remifentanil or labetalol. Labetalol significantly attenuated the rise in BP and HR during laryngoscopy and intubation compared to remifentanil (P<0.001). Eventually, no significant difference was found between the Apgar scores of the two groups (P=0.97 and P=0.19, respectively). Conclusion: Overall, the administration of labetalol before the inspiration of anesthesia can control stress replication to laryngoscopy and shows better intubation and more stability than remifentanil in patients with severe preeclampsia undergoing C-section.

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Nasal Itching And Bleeding Due To Excessive Exposure To Air Conditioners

Journal of Bahria University Medical and Dental College ◽

10.51985/jbumdc2018002 ◽

2017 ◽

Vol 08 (01) ◽

pp. 03-07

Author(s):

Adnan Asghar ◽

Anwar ul Haq ◽

Syed Shaukat Hussain ◽

Muhammad Khan ◽

Asif Alam Gul

Keyword(s):

Nasal Mucosa ◽

Cold Weather ◽

Elderly Subjects ◽

P Value ◽

Age Group ◽

Chi Square ◽

Cold Air ◽

Air Conditioners ◽

Significant Difference ◽

Nasal Bleeding

Introduction: Nasal mucosa is very sensitive when it is exposed to extreme dry and cold weather conditions. Persistent or recurrent nasal itching due to such exposure is usually followed by the epistaxis. Objective of the study was to analyze effects of excessive exposure to dry and cold air of air conditioners on nose in terms of nasal itching and epistaxis. Methods: This prospective cohort study carried out on 144 healthy Pakistani individuals working in United Nations Hospital in Nyala, Sudan from February 2014 to May 2014. Individuals spending less than 8 hours daily inside air conditioners were compared to those spending more than 15 hours daily. Chi square tests were applied to compare the proportions of incidence of nasal itching and epistaxis between these two groups as well as between two age groups. Results: Mean age of all 144 subjects was 35.01 years (± 6.4). Chi square test results confirmed that there was statistically significant difference of both the symptoms (nasal itching p-value 0.021 and nasal bleeding p-value 0.044) between two groups. Those spending more time in air conditioners were significantly more affected by dry and cold air. As for as the age group is concerned significantly higher number of subjects of ages more than 40 years had nasal bleeding compared to the younger age group (equal or less than 40 years). Conclusion: Effects of exposure of dry air of air conditioners on nasal mucosa in terms of nasal itching and nasal bleeding were found to be significantly higher when subjects were exposed 15 hours or more per day. Furthermore nasal bleeding was more commonly seen in elderly subjects (more than 40 years) due to such exposure

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Effect of Intravenous Lignocaine in Attenuating Dexamethasone Induced Perineal Pruritus During Induction of Anesthesia

KYAMC Journal ◽

10.3329/kyamcj.v9i4.40142 ◽

2019 ◽

Vol 9 (4) ◽

pp. 144-147

Author(s):

Muhammad Sazzad Hossain ◽

Md Afzalur Rahman ◽

Mohammad Mamunur Rashid ◽

Mohammad Ifta Khairul Hasan ◽

Muhammad Alamgir Mandal ◽

...

Keyword(s):

Placebo Group ◽

General Anesthesia ◽

Normal Saline ◽

Sodium Phosphate ◽

Demographic Data ◽

Double Blind Study ◽

Analog Scale ◽

Double Blind ◽

Group I ◽

Significant Difference

Background: Intravenous dexamethasone may produce perineal pruritus in some patients when administered as premedicant before induction of anesthesia. Objectives of study: This randomized, double-blind study was done to evaluate the efficacy of pretreatment of lignocaine on the incidence and severity of dexamethasone-induced perineal pruritus. Materials and methods: 100 patients were enrolled in this study and allocated randomly into two equal groups. Then, patients received intravenous medications in the following sequence before induction of anesthesia: in group I, injection lignocaine 1mg/kg diluted in 5 ml normal saline and in group II, 5 ml normal saline (placebo group), then one minute later, intravenous dexamethasone sodium phosphate 10 mg was given in all groups in 3 seconds and was observed the patient's response about perineal pruritus. The severity of perineal pruritus was graded based on the visual analog scale (VAS) as none (VAS 0), mild (VAS 1-3), moderate (VAS 4-6), or severe (VAS 7-10), and recorded the incidence and severity of perineal pruritus. Then general anesthesia was induced and continued as usual. Results: In terms of demographic data, the results of this study showed that there was no significant difference between patients in both groups (P>0.05). Overall incidence and severity of perineal pruritus in lignocaine group was significantly less, when compared with placebo group (P<0.05). Conclusion: It can be concluded that pretreatment with 1mg/kg intravenous lignocaine may effectively reduce the incidence and severity of dexamethasone induced perineal pruritus. KYAMC Journal Vol. 9, No.-4, January 2019, Page 144-147

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Effects of Perioperative Rosuvastatin for Postoperative Delirium After Elderly General Anesthesia Patients: A Randomized, Double-Blind, and Placebo-Controlled Trial

10.21203/rs.3.rs-182547/v1 ◽

2021 ◽

Author(s):

Xiaoqin Xu ◽

Jingzhi Luo ◽

Xiaoyu Li ◽

Haiqin Tang ◽

Weihong Lu

Keyword(s):

Clinical Trials ◽

General Anesthesia ◽

Clinical Outcomes ◽

Postoperative Delirium ◽

Controlled Trial ◽

Statistical Significance ◽

Care Providers ◽

Double Blind ◽

Significant Difference ◽

To Receive

Abstract Background: Experimental evidence has indicated the benefits of statins for the treatment of postoperative delirium. Previously clinical trials had no definite conclusions of statins on delirium. Some clinical trials indicated statins can reduce postoperative delirium and improve outcome, while some studies showed negative results. Therefore, the present study tries to evaluate whether perioperative rosuvastatin treatment could reduce the incidence of delirium and improve clinical outcomes. Methods: This was a randomized, double-blind, and placebo-controlled trial in a single-center in Jiangsu, China. This study enrolled patients aged more than 60 years old who present selective general anesthesia operation, with informed consent. A computer-generated randomization sequence (in a 1:1 ratio) was used to randomly assign patients to receive either rosuvastatin (40 mg/day) or placebos. Participants, care providers, and investigators were all masked to group assignment. The primary endpoint was the incidence of delirium, assessed twice daily with the Confusion Assessment Method during the first 7 postoperative days. Analyses were performed by intention-to-treat and safety populations. Results: Between Jan 1, 2017, and Jan 1, 2020, 3512 patients were assessed. A total of 821 were randomly assigned to receive either a placebo (n=411) or rosuvastatin (n=410). The incidence of postoperative delirium was significantly lower in the rosuvastatin group (23 [5.6%] of 410 patients) than the placebo group (42 [13.5%] of 411 patients (OR=0.522, 95% CI 0.308-0.885; p<0.05). No significant difference on 30-day all-cause mortality (6.1% vs 8.7 %, OR 0.67, P=0.147, 95% CI 0.39–1.2) between two groups. Rosuvastatin can decrease the hospitalization time (13.8±2.5 vs 14.2±2.8, P=0.03) and hospitalization expenses (9.3±2.5 vs 9.8±2.9, P=0.007). No statistical significance between the two groups on abnormal liver enzymes (9.0% vs 7.1%, P=0.30, OR=1.307, 95% CI 0.787-2.169) and rhabdomyolysis (0.73% vs 0.24%, P=0.37, OR=3.020, 95% CI 0.31-29.2. Conclusion: The current study suggests that perioperative rosuvastatin treatment can reduce the incidence of delirium after elective general anesthesia operation. However, no evidence was found that rosuvastatin can improve clinical outcomes. The therapy was safe. Further investigation is necessary to fully understand the potential usefulness of dexmedetomidine in older patients. Trial registration: chictr.org.cn, ChiCTR-IPR-17011984(Registered date: 13/07/2017). The manuscript adheres to CONSORT guidelines.

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