scholarly journals Dexmedetomidine might improve postoperative cognitive dysfunction in older patients undergoing pulmonary surgery

2021 ◽  
Author(s):  
Tao LIU ◽  
Chao Fang Liu ◽  
Jun Tai Luo ◽  
Xia YU ◽  
Bin Chen ◽  
...  
Keyword(s):  
Placebo Group ◽  
Cognitive Function ◽  
Older Patients ◽  
Near Infrared ◽  
Postoperative Cognitive Dysfunction ◽  
Controlled Study ◽  
Anesthesia Induction ◽  
Pulmonary Surgery ◽  
Significant Difference ◽  
First Time

Abstract Background The effect of dexmedetomidine on cognitive function after various surgeries were reported, however no consensus is made on pulmonary surgery. In this study we aimed at investigating the effect of dexmedetomidine anesthesia on postoperative cognitive function (POCD) in pulmonary surgery. Methods A prospective randomized placebo-controlled study was conducted with blinded to patients. The study was performed on 60 patients (29 in the dexmedetomidine group; 31 in the placebo group). Dexmedetomidine-group patients received dexmedetomidine (1 µg/kg, i.v.) and Placebo-group patients received an equal volume of physiologic (0.9%) saline for 20 min before anesthesia induction. Cognitive function was evaluated using Montreal Cognitive Assessment (MoCA) 1 day before surgery, as well as on postoperative day (POD)1, POD3 and POD7. The regional cerebral oxygen saturation (rSO2) was monitored continuously by near-infrared spectroscopy before anesthesia. Results The MoCA score between the two groups was significantly different on POD1 (Dex 26.4 ± 0.73 vs Placebo 25.5 ± 0.96, p < 0.001) and POD3 (Dex 27.1 ± 0.79 vs Placebo 26.6 ± 0.80, p = 0.032). In detail, attention and orientation scores were increased in the dexmedetomidine group on POD1 and POD3. The rSO2 between the dexmedetomidine group or placebo group was not significantly different (Dex 64.9 ± 2.73 vs. Placebo 64.3 ± 3.29, p = 0.483), and no significant difference was found before drug administration and after regaining consciousness (Dex 63.5 ± 2.52 vs. Placebo 64.2 ± 3.22; p = 0.390). Conclusion We showed, for the first time, that dexmedetomidine (1.0 µg/kg) could reduce the risk of POCD and might not decrease rSO2. Hence, dexmedetomidine could be employed in pulmonary surgical procedures, especially for older patients facing high risk of delirium.

scholarly journals Effects of sevoflurane and propofol on the optic nerve sheath diameter in patients undergoing laparoscopic gynecological surgery: A Randomized controlled clinical studies

2021 ◽  
Author(s):  
Weilian Geng ◽  
Changxing Chen ◽  
Xingfeng Sun ◽  
Shaoqiang Huang
Keyword(s):  
Optic Nerve ◽  
Optic Nerve Sheath Diameter ◽  
Optic Nerve Sheath ◽  
Controlled Study ◽  
Anesthesia Induction ◽  
Gynecological Surgery ◽  
Time Points ◽  
Randomized Controlled ◽  
Nerve Sheath ◽  
Significant Difference

Abstract Background The results of studies on changes in intracranial pressure in patients undergoing laparoscopic surgery are inconsistent. Meanwhile, previous neurosurgery studies have suggested that propofol and sevoflurane have inconsistent effects on cerebral blood flow and cerebrovascular self-regulation. The purpose of this study is to compare changes in the optic nerve sheath diameter in patients undergoing laparoscopic gynecological surgery under anesthetic maintenance with propofol versus sevoflurane. Methods This study included 110 patients undergoing laparoscopic gynecological surgery with an estimated operative time of more than 2 hours under general anesthesia. The study was a randomized controlled study. The optic nerve sheath diameter（ONSD）at various time points was measured by ultrasound, including when the patients entered the operating room (Tawake), after successful anesthesia induction and endotracheal intubation (Tinduction), when the body position was adjusted to the Trendelenburg position and the CO2 pneumoperitoneum pressure reached 14 mmHg, which was recorded as T0. Then, measurements were conducted every 15 minutes for the first 1 hour and then once every hour until the end of the surgery（T15,T30,T45 ,T1h ,T2h…）, after the end of surgery and the tracheal tube was removed (Tend), and before the patients were transferred to the ward (Tpacu).Results A significant difference in optic nerve sheath diameter was found between two groups at T15, T30, T45 (4.64±0.48mm and 4.50±0.29mm, respectively, p=0.031;4.77±0.45mm and 4.62±0.28mm, respectively, p=0.036;4.84±0.46mm and 4.65±0.30mm, respectively, p=0.012), while there was no significant difference at Tawake and other time points. Conclusion During laparoscopic gynecological surgery lasting more than 2 hours, the optic nerve sheath diameter was slightly larger in the propofol group than that in the sevoflurane group in the first 45 minutes. No significant difference was observed between the two groups 1 hour after surgery. Trial registration clinicaltrials.gov，NCT03498235. Retrospectively registered 1 March2018,https://register.clinicaltrials.gov/prs/app/action/SelectProtocol?sid=S0007UMM&selectaction=Edit&uid=U00040C5&ts=39&cx=c7i8icThe manuscript adheres to CONSORT guidelines.

Predictive Value of Charlson Comorbidity Index and Cofactors on 2-Year Mortality in Older Patients With Intertrochanteric Fractures: A Retrospective Analysis

2021 ◽  
Author(s):  
Jianda Xu ◽  
Homma Yasuhiro ◽  
Yuta Jinnai ◽  
Tomonori Baba ◽  
Zhuang Xu ◽  
...  
Keyword(s):  
Blood Loss ◽  
Older Patients ◽  
Demographic Data ◽  
Survival Rates ◽  
Operation Time ◽  
Intertrochanteric Fractures ◽  
Time Out ◽  
Time Operation ◽  
Significant Difference ◽  
First Time

Abstract The aim of this study was to evaluate the role of Charlson comorbidities index (CCI) and cofactors on 2-year mortality in older patients with intertrochanteric fractures. 60 cases with unilateral intertrochanteric fracture were retrospectively analyzed and divided into Low-CCI group (CCI: 1-4) or high-CCI groups (CCI: 5-6). All the patients’ electronic hospital records were reviewed. The preoperative situations (demographic data, comorbidities and fracture conditions), perioperative situations (wait time, operation time, implant choice, blood loss, transfusion or not) and postoperative situations (complications, first time out of bed, function about 1-/2- week and 2-year mortality) were recorded. 51.67% were in low-CCI group and 48.33% in high-CCI group. The survival rates in low- and high-CCI group were 93.5% and 86.2 % respectively. According to the functional results of 1- or 2- week after operation, no significant difference was found (P=0.955, 0.140). Log-rank analysis showed that the main prognostic factors were blood loss, first time out of bed and complication (P<0.05). Multivariate analysis confirmed that complication and first time out of bed were significant factor on survival rate (P=0.029, 0.010). Charlson comorbidities index maybe not the indicator of 2-year mortality in older patients with intertrochanteric fractures. In order to improve the prognosis, more attentions should be paid to reduce the complications and encourage postoperative earlier excise out of bed.

scholarly journals A 12-Week, Multicenter, Randomized, Double-Blind, Placebo-Controlled Clinical Trial for Evaluation of the Efficacy and Safety of DKB114 on Reduction of Uric Acid in Serum

Nutrients ◽  
2020 ◽  
Vol 12 (12) ◽  
pp. 3794
Author(s):  
Yu Hwa Park ◽  
Do Hoon Kim ◽  
Jung Suk Lee ◽  
Hyun Il Jeong ◽  
Kye Wan Lee ◽  
...  
Keyword(s):  
Clinical Trial ◽  
Uric Acid ◽  
Placebo Group ◽  
Serum Uric Acid ◽  
Controlled Study ◽  
Efficacy And Safety ◽  
Food Ingredient ◽  
Double Blind ◽  
Double Blind Placebo ◽  
Significant Difference

This study sought to investigate the antihyperuricemia efficacy and safety of DKB114 (a mixture of Chrysanthemum indicum Linn flower extract and Cinnamomum cassia extract) to evaluate its potential as a dietary supplement ingredient. This clinical trial was a randomized, 12-week, double-blind, placebo-controlled study. A total of 80 subjects (40 subjects with an intake of DKB114 and 40 subjects with that of placebo) who had asymptomatic hyperuricemia (7.0–9.0 mg/dL with serum uric acid) was randomly assigned. No significant difference between the DKB114 and placebo groups was observed in the amount of uric acid in serum after six weeks of intake. However, after 12 weeks of intake, the uric acid level in serum of subjects in the DKB114 group decreased by 0.58 ± 0.86 mg/dL and was 7.37 ± 0.92 mg/dL, whereas that in the placebo group decreased by 0.02 ± 0.93 mg/dL and was 7.67 ± 0.89 mg/dL, a significant difference (p = 0.0229). In the analysis of C-reactive protein (CRP) change, after 12 weeks of administration, the DKB114 group showed an increase of 0.05 ± 0.27 mg/dL (p = 0.3187), while the placebo group showed an increase of 0.10 ± 0.21 mg/dL (p = 0.0324), a statistically significant difference (p = 0.0443). In the analysis of amount of change in apoprotein B, after 12 weeks of administration, the DKB114 group decreased by 4.75 ± 16.69 mg/dL (p = 0.1175), and the placebo group increased by 3.13 ± 12.64 mg/dL (p = 0.2187), a statistically significant difference between the administration groups (p = 0.0189). In the clinical pathology test, vital signs and weight measurement, and electrocardiogram test conducted for safety evaluation, no clinically significant difference was found between the ingestion groups, confirming the safety of DKB114. Therefore, it may have potential as a treatment for hyperuricemia and gout. We suggest that DKB114 as a beneficial and safe food ingredient for individuals with high serum uric acid. Trial registration (CRIS.NIH. go. Kr): KCT0002840.

scholarly journals Efficacy of tranexamic acid in reducing blood loss, blood and blood products requirements in Cesarian sections for patients with placenta accreta

2019 ◽  
Vol 11 (1) ◽  
Author(s):  
Tamer Hamed Ibrahim
Keyword(s):  
Platelet Count ◽  
Placebo Group ◽  
Blood Loss ◽  
Tranexamic Acid ◽  
Placenta Accreta ◽  
Controlled Study ◽  
Intraoperative Blood Loss ◽  
Blood Products ◽  
Coagulation Profile ◽  
Significant Difference

Abstract Background Placenta accreta is an obstetric emergency and the main cause of maternal morbidity and mortality due to the associated bleeding and coagulopathy. Tranexamic acid has been widely used to decrease blood loss in trauma patients and patients with postpartum hemorrhage. We aimed at studying the effect of tranexamic acid in reducing blood loss and blood transfusion in patients with placenta accreta. Methods In a double-blinded randomized controlled study, 46 patients were recruited and divided into two groups, Group A is the tranexamic group where patients received 10 mg/kg tranexamic acid after cord clamping and continued on tranexamic infusion 10 mg/kg/h till the end of the surgery. Group B is the placebo where patients received normal saline instead. Primary outcome was the amount of intraoperative blood loss, and other outcomes included the number of blood and blood products transfused intraoperative and in the first 24 h postoperative, the immediate postoperative Hb level, platelet count, and coagulation profile. Data were collected, coded, tabulated, and then analyzed using Minitab® 16.1.0 statistics software package. Variables were presented as mean and standard deviation and analyzed using unpaired t test. Any difference with p value < 0.05 was considered statistically significant. Results Amount of intraoperative blood loss was significantly less in the tranexamic group 2232 ± 1204 ml compared to the placebo group 3405 ± 1193 ml (p value 0.002), and patients in the tranexamic group received less units of packed red blood cells, fresh frozen plasma, and platelets compared to those in the placebo group (4.2 ± 1.9 vs 6.1 ± 2.2 with p value 0.003, 3.4 ± 1.3 vs 4.2 ± 1.2 with P value 0.036 and 4.8 ± 2.1 vs 6.2 ± 2.4 with p value 0.041, respectively). There was no statistically significant difference in the first postoperative Hb level, platelet count, and coagulation profile between the two groups; however, the amount of blood and products transfused in the first 24 h postoperative were significantly less in the tranexamic group Conclusion Tranexamic acid infusion was effective in reducing intraoperative blood loss and intraoperative and postoperative blood and blood products’ transfusion.

Pyridoxine is not effective for the prevention of hand foot syndrome (HFS) associated with capecitabine therapy: Results of a randomized double-blind placebo-controlled study

2007 ◽  
Vol 25 (18_suppl) ◽  
pp. 9007-9007 ◽  
Author(s):  
S. Lee ◽  
S. Lee ◽  
Y. Chun ◽  
M. Kim ◽  
H. Chang ◽  
...  
Keyword(s):  
Placebo Group ◽  
Chemotherapy Regimen ◽  
Controlled Study ◽  
Double Blind Study ◽  
Double Blind ◽  
Significant Difference ◽  
Hand Foot Syndrome ◽  
Version 2.0 ◽  
The Mean ◽  
To Receive

9007 Introduction: Although pyridoxine has been used empirically for the prevention of HFS associated with capecitabine, its efficacy has not been proven yet. We performed a prospective randomized double-blind study to determine whether pyridoxine can prevent the development of HFS when given concurrently with capecitabine. Method: Chemotherapy-naive patients (pts) with gastrointestinal tract cancers who were going to have capecitabine-containing chemotherapy were randomized to receive either oral pyridoxine (200 mg/day) or placebo daily during chemotherapy after stratified by chemotherapy regimen: 1) capecitabine alone, 2) capecitabine and cisplatin, or 3) docetaxel, capecitabine, and cisplatin. The patients were observed until grade 2 or 3 HFS (by NCI CTC version 2.0) developed or capecitabine containing chemotherapy ended. When grade 2 or 3 HFS developed in pts in placebo group, the pts were randomized again to receive either pyridoxine or placebo for next cycle of chemotherapy in order to determine whether pyridoxine could improve the HFS. Result: From Jun 2004 to Oct 2005, total 389 pts were entered onto the study. But, 29 pts (15 in placebo group and 14 in pyridoxine group) were excluded from the study because of ineligibility or pts’ refusal. Pts’ characteristics were well balanced between the 2 groups. Grade 2 or 3 HFS developed in 55 of 180 (30.6%) pts in placebo group and in 57 of 180 (31.7%) pts in pyridoxine group. (p=0.788) The median cycles of chemotherapy to grade 2 or 3 HFS was 3 in both groups. The mean cumulative dose of capecitabine until occurrence of grade 2 or 3 HFS was not different statistically between the two groups. (221,157.5 mg/m2 vs. 259,808.5 mg/m2, p=0.788). Total 44 of 55 pts in placebo group who had grade 2 or 3 HFS were randomized to receive either placebo or pyridoxine at next cycle. There was no significant difference between the two groups in the proportion of pts with improvement of HFS (43% vs 48%, p=0.94). Conclusion: These results indicated that pyridoxine is not effective for the prevention of HFS associated with capecitabine therapy. No significant financial relationships to disclose.

scholarly journals ОТДАЛЕННАЯ ПОСЛЕОПЕРАЦИОННАЯ КОГНИТИВНАЯ ДИСФУНКЦИЯ

World Science ◽  
2018 ◽  
pp. 50-53
Author(s):  
Дубовская С. С. ◽  
Товажнянская Е. Л. ◽  
Григоров Ю. Б. ◽  
Кудинова О. В. ◽  
Соловйова Е. Т.
Keyword(s):  
Cognitive Function ◽  
Postoperative Cognitive Dysfunction ◽  
Young Patients ◽  
Aged Patients ◽  
Word Memory Test ◽  
Word Memory ◽  
Age Related ◽  
Complete Restoration ◽  
Significant Difference ◽  
Late Postoperative Period

Postoperative cognitive dysfunction develops in the early and persists in the late postoperative period. Clinically, this condition manifests itself in the form of memory impairment, violation of concentration and violation of other higher functions of the cerebral cortex. The aim of this study is to study cognitive function in patients who underwent surgery with the use of general anesthesia in a remote period in a month.According to the results of the MMSE test, in the middle-aged patients the dynamics of the deterioration of the cognitive function was observed to a lesser degree than in the young patients, which is probably related to the age-related features of the plasticity of the cognitive function. In patients of middle age, according to the results of the FAB scale, at this period of the study was at the same level as those in young patients, which is associated with the age specificity of the plasticity of the cognitive function. According to the test drawing hours, there was no significant difference in the recovery rate, it was gradual, but no complete restoration was observed. For the 10-word memory test and the Schulte trial, the recovery was gradual, with a full recovery of the indicator to the level before the operation.

scholarly journals Effect of dexmedetomidine on prevention of postoperative nausea and vomiting in pediatric strabismus surgery: A randomized controlled study

2020 ◽  
Author(s):  
shuangshuang li ◽  
Tingjie Liu ◽  
Junming Xia ◽  
Jie Jia ◽  
Wenxian Li
Keyword(s):  
Placebo Group ◽  
Postoperative Nausea ◽  
Recovery Time ◽  
Pediatric Patients ◽  
Postoperative Nausea And Vomiting ◽  
Strabismus Surgery ◽  
Nausea And Vomiting ◽  
Controlled Study ◽  
Extubation Time ◽  
Significant Difference

Abstract Background : Postoperative nausea and vomiting (PONV) are common side-effects following strabismus surgery. The present study aimed to compare the effects of different doses of dexmedetomidine (DEX) on PONV incidence in pediatric patients undergoing strabismus surgery. Methods : In this prospective randomized double-blinded study, 126 pediatric patients undergoing strabismus surgery were randomized into one of three groups: Placebo group, normal saline; DEX1 group, 0.3 ug/kg dexmedetomidine, and DEX2 group, 0.5 ug/kg dexmedetomidine. Oculocardiac reflex (OCR) events were recorded during surgery. PONV or postoperative vomiting (POV) was recorded for 24 hours in the ward. Pediatric anesthesia emergence delirium (PAED) scale and emergence agitation (EA) scale were recorded in the recovery room. Results : Intraoperative OCR was significantly reduced in DEX2 group (42%) as compared to that of Placebo group (68%) (p=0.0146). During the first 24 hours post-op, the overall incidence of PONV was significantly lower in DEX2 group (10%) than that of Placebo group (32%) (p=0.0142). There was no significant difference in POV among the three groups. PAED or EA scores among the three groups were similar during recovery time. Conclusion : Dexmedetomidine (0.5 ug/kg) reduced OCR and PONV without lengthening extubation time or recovery time in pediatric patients undergoing strabismus surgery.

scholarly journals Effect of dexmedetomidine on prevention of postoperative nausea and vomiting in pediatric strabismus surgery: A randomized controlled study

2019 ◽  
Author(s):  
shuangshuang li ◽  
Tingjie Liu ◽  
Junming Xia ◽  
Jie Jia ◽  
Wenxian Li
Keyword(s):  
Placebo Group ◽  
Postoperative Nausea ◽  
Recovery Time ◽  
Pediatric Patients ◽  
Postoperative Nausea And Vomiting ◽  
Strabismus Surgery ◽  
Nausea And Vomiting ◽  
Controlled Study ◽  
Extubation Time ◽  
Significant Difference

Abstract Background Postoperative nausea and vomiting (PONV) are common side-effects following strabismus surgery. The present study aimed to compare the effects of different doses of dexmedetomidine (DEX) on PONV incidence in pediatric patients undergoing strabismus surgery. Methods In this prospective randomized double-blinded study, 126 pediatric patients undergoing strabismus surgery were randomized into one of three groups: Placebo group, normal saline; DEX1 group, 0.3 ug/kg dexmedetomidine, and DEX2 group, 0.5 ug/kg dexmedetomidine. Oculocardiac reflex (OCR) events were recorded during surgery. PONV or postoperative vomiting (POV) was recorded for 24 hours in the ward. Pediatric anesthesia emergence delirium (PAED) scale and emergence agitation (EA) scale were recorded in the recovery room. Results Intraoperative OCR was significantly reduced in DEX2 group (41.5%) as compared to that of Placebo group (68.3%) (p=0.026). During the first 24 hours post-op, the overall incidence of PONV was significantly lower in DEX2 group (9.8%) than that of Placebo group (31.7%) (p=0.029). There was no significant difference in POV among the three groups. PAED or EA scores among the three groups were similar during recovery time. Conclusion Dexmedetomidine (0.5 ug/kg) reduced OCX and PONV without lengthening extubation time or recovery time in pediatric patients undergoing strabismus surgery.

scholarly journals Efficacy and Safety of MLC601 in the Treatment of Mild Cognitive Impairment: A Pilot, Randomized, Double-Blind, Placebo-Controlled Study

2017 ◽  
Vol 7 (1) ◽  
pp. 136-142 ◽  
Author(s):  
Hossein Pakdaman ◽  
Ali Amini Harandi ◽  
Mehdi Abbasi ◽  
Hosein Delavar Kasmaei ◽  
Farzad Ashrafi ◽  
...  
Keyword(s):  
Cognitive Impairment ◽  
Placebo Group ◽  
Mild Cognitive Impairment ◽  
Cognitive Function ◽  
Disease Assessment ◽  
Controlled Study ◽  
Efficacy And Safety ◽  
Double Blind ◽  
Double Blind Placebo ◽  
Global Cognitive Function

Background and Aim: Mild cognitive impairment (MCI) is characterized by declined cognitive function greater than that expected for a person’s age. The clinical significance of this condition is its possible progression to dementia. MLC601 is a natural neuroprotective medication that has shown promising effects in Alzheimer disease. Accordingly, we conducted this randomized, double-blind, placebo-controlled study to evaluate the efficacy and safety of MLC601 in MCI patients. Methods: Seventy-two patients with a diagnosis of MCI were recruited. The included participants were randomly assigned to groups to receive either MLC601 or placebo. An evaluation of global cognitive function was performed at baseline as well as at 3-month and 6-month follow-up visits. Global cognitive function was assessed by Mini-Mental State Examination (MMSE) and Alzheimer’s Disease Assessment Scale-cognitive subscale (ADAS-cog) scores. Efficacy was evaluated by comparing global function scores between the 2 groups during the study period. Safety assessment included adverse events (AEs) and abnormal laboratory results. Results: Seventy patients completed the study, 34 in the MLC601 group and 36 in the placebo group. The mean changes (±SD) in cognition scores over 6 months in the MLC601 group were –2.26 (±3.42) for the MMSE and 3.82 (±6.16) for the ADAS-cog; in the placebo group, they were –2.66 (±3.43) for the MMSE and 4.41 (±6.66) for the ADAS-cog. The cognition changes based on both MMSE and ADAS-cog scores were statistically significant between the placebo and the MLC601 group (p < 0.001). Only 5 patients (14.7%) reported minor AEs in the MLC601 group, the most commonly reported of which were gastrointestinal, none of them leading to patient withdrawal. Conclusion: MLC601 has shown promising efficacy and acceptable AEs in MCI patients.

scholarly journals L-Carnitine supplementation ameliorates serum tumor necrosis factor-alpha and matrix metalloproteinase-3 in knee osteoarthritis women

2017 ◽  
Vol 12 (1) ◽  
pp. 28 ◽  
Author(s):  
Reza Mahdavi ◽  
Sousan Kolahi ◽  
Vahideh Ebrahimzadeh Attari ◽  
Aida Malek Mahdavi
Keyword(s):  
Placebo Group ◽  
Knee Osteoarthritis ◽  
Global Assessment ◽  
Intervention Group ◽  
Controlled Study ◽  
Carnitine Supplementation ◽  
Double Blind ◽  
Necrosis Factor Alpha ◽  
Matrix Metalloproteinase 3 ◽  
Significant Difference

<p class="Abstract">Seventy-two females with mild to moderate knee osteoarthritis were included in this randomized double-blind placebo-controlled study. Patients in the intervention group (n=36) received L-carnitine supplement (750 mg/day) for two months. L-Carnitine supplementation led to decrease in serum TNF-α and MMP-3 levels significantly in comparison with the baseline (p&lt;0.001 and p&lt;0.001, respectively) and placebo group (p&lt;0.001 and p=0.03, respectively). In addition, physician’s global assessment of the severity of osteoarthritis decreased significantly in the L-carnitine group (p&lt;0.001) and placebo group (p=0.012) after supplementation. At the end of the study, a significant difference was observed between the two groups for mean physician’s global assessment of the severity of osteoarthritis (p&lt;0.001), adjusted for baseline values and duration of osteoarthritis. L-Carnitine supplementation has beneficial effects in reducing inflammatory biomarkers in knee osteoarthritis patients which subsequently leads to the alleviation of disease symptoms.</p>

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