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Objective To evaluate the effect of early postoperative delirium on prognosis in the pa-tients undergoing coronary artery bypass graft in a nested case control study. Methods A total of 308 pa-tients scheduled for elective coronary artery bypass graft were divided into delirium group or non-delirium group according to whether early postoperative delirium occurred. Type of surgery (on-pump or off-pump) and difference of EuroSCORE between two cases ≤2 were considered as criteria, and patients in two groups were matched with a ratio of 1 : 1. The development of complications was observed within 28 days after op-eration. The development of complications developed after delirium was recorded in delirium group. Results The incidence of delirium was 46. 4％. The total incidence of complications, postoperative cardiac insuf-ficiency and incidence of arrhythmia were significantly higher in delirium group than in non-delirium group (P<0. 05). Conclusion Early postoperative delirium is not helpful for the prognosis in the patients under-going coronary artery bypass graft.
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Objective To evaluate the effect of early postoperative delirium on outcomes in elderly patients undergoing joint replacement.Methods Elderly patients,aged ≥ 60 yr,of American Society of Anesthesiologists physical status Ⅰ-Ⅲ,scheduled for elective hip or knee joint replacement,were divided into delirium group and non-delirium group according to whether the patients developed postoperative delirium.The case-matching criteria was set up with difference in age less than 5 yr and difference in Charlson comorbidity index less than 2 and with a ratio of 1 ∶ 4 for match.The development of complications was recorded within 28 days after operation.Complications happened after delirium was recorded in delirium group.Results There were 53 cases in delirium group and 212 cases in non-delirium group.There was no significant difference in preoperative baseline data or intraoperative variables between two groups (P ＞0.05).Compared with non-delirium group,the total incidence of postoperative complications was significantly increased,the incidence of postoperative cognitive dysfunction,cardiovascular complications,pulmonary complications and deep venous thrombosis was increased,and the length of hospitalization was prolonged in delirium group (P＜0.05).Conclusion Early postoperative delirium is not helpful for outcomes in elderly patients undergoing joint replacement.
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ObjectiveTo investigate the effect of cholinesterase inhibitor on endotoxin-induced brain injury in rabbits.Methods Twenty-one healthy male rabbits were randomly assigned into three groups ( n ＝ 7each):group sham operation (group S),lipopolysaccharide (LPS) group and cholinesterase inhibitor (tacrine hydrochloride,THA) group.LPS 200 μg/kg was intracerebroventricularly injected in LPS group,LPS 200μg/kgand tacrine hydrochloride 150 μg/kg were injected in THA group,while same volume of normal saline was injected in S group.Then blood and tissue samples were collected in different groups after 4 hours.Nuclear factor-kappa B (NF-κB) p65 activity of brain tissues was determined by using Western blot analysis.Tumor necrosis factor-alpha (TNF-α) levels in plasma,cerebrospinal fluid and brain tissues were measured using enzyme linked immunosorbent assay.The brain tissue's myeloperoxidase (MPO) activity and the ratio of wet to dry weight (W/D) were also analyzed.ResultsAs compared with S group,TNF-α level in plasma,cerebrospinal fluid and brain tissues,NF-κB p65 level,MPO activity and W/D ratio increased in LPS and THA groups (P < 0.05).When compared with LPS group,TNF-α level in plasma,cerebrospinal fluid and brain tissues,NF-κB p65 level,MPO activity and W/D ratio decreased in THA group ( P < 0.05 ).ConclusionCholinesterase inhibitor can attenuate the endotoxin-induced brain injury through inhibiting local inflammatory responses.