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Effect of pre-infusion of hypertonic saline on postoperative delirium in geriatric patients undergoing shoulder arthroscopy: a randomized controlled trial.
- Source :
- BMC Anesthesiology; 12/11/2023, Vol. 23 Issue 1, p1-10, 10p
- Publication Year :
- 2023
-
Abstract
- Background: Neuroinflammation may be a potential mechanism of postoperative delirium (POD) in geriatric patients, and hypertonic saline (HS) has immunomodulatory properties. The purpose of this study was to investigate whether HS could reduce the incidence of POD in elderly patients and its effect on neutrophil activation and inflammatory cytokine expression. Methods: We studied the effect of pre-infusion of 4 mL/kg 3% hypertonic saline vs. 4 mL/kg 0.9% normal saline on POD in patients undergoing shoulder arthroscopy in a prospective, randomized, double-blind, controlled trial. Neutrophil surface molecules (CD11b, CD66b and CD64) were analyzed by flow cytometry. Circulating concentrations of inflammatory factors IL-1β, IL-6, TNF-α and neurological damage factor S100β were assessed by enzyme immunoassay. The Confusion Assessment Method-Chinese Revision (CAM-CR) was applied for the assessment of POD 1–3 days after surgery. Results: The incidence of POD in group H was significantly lower than that in group N (7.14% vs 26.83%, P = 0.036). The expression levels of inflammatory cytokines (IL-6 and TNF-α) and neutrophil surface markers (CD11b and CD66b) were significantly lower in group H than in group N at 24 h after surgery (P = 0.018, P < 0.001, P < 0.001, P = 0.024). There were no significant differences in postoperative pain, nausea and vomiting, infection, phlebitis, and patients satisfaction between the two groups. Conclusion: Pre-infusion of HS can reduce the incidence of POD and the immune-inflammatory response. Trial registration: Chinese Clinical Trial Registry (14/4/2022, registration number: ChiCTR2200058681. [ABSTRACT FROM AUTHOR]
- Subjects :
- PREVENTION of surgical complications
SHOULDER joint surgery
CYTOKINES
FLOW cytometry
INTERLEUKINS
ARTHROSCOPY
DISEASE incidence
PATIENT satisfaction
NEUTROPHILS
TREATMENT effectiveness
RANDOMIZED controlled trials
COMPARATIVE studies
DELIRIUM
IMMUNITY
BLIND experiment
TUMOR necrosis factors
IMMUNOENZYME technique
DESCRIPTIVE statistics
RESEARCH funding
HYPERTONIC saline solutions
STATISTICAL sampling
ELDER care
PHYSIOLOGIC salines
OLD age
Subjects
Details
- Language :
- English
- ISSN :
- 14712253
- Volume :
- 23
- Issue :
- 1
- Database :
- Complementary Index
- Journal :
- BMC Anesthesiology
- Publication Type :
- Academic Journal
- Accession number :
- 174162732
- Full Text :
- https://doi.org/10.1186/s12871-023-02340-5