Abstract

Purpose

We hypothesized that remote ischemic preconditioning (RIPC) could improve postoperative cognitive dysfunction (POCD) in elderly patients following laparoscopic cholecystectomy (LC).

Patients and Methods

Eighty-eight patients were randomly assigned to either the control or the RIPC group. The RIPC was applied on the right upper limb using a blood pressure cuff inflating 200 mmHg, consisting of 3 cycles of 5 min ischemia and 5 min reperfusion. Serum concentrations of Neuron-specific Enolase (NSE) and Brain-Derived Neurotrophic Factor (BDNF) were collected at one-day preoperative (T0), at the end of the operation (T4) and one-day postoperative (T5). score was tested at T0 and 3 days after the operation (T6). POCD was determined if there were two scores ≥1.96 at the same time or an average score ≥1.96.

Results

There was no significant difference in the score of each test between the two groups at T0 ( > 0.05). Notably, the duration of Stroop test C was significantly shorter in the RIPC group than that in the Control group at T6 ( = 0.01). POCD occurred in 1/44 (2.3%) patients in the RIPC group and 8/44 (18.2%) patients in the control group at T6 (=0.035). In addition, serum NSE concentration was significantly decreased, but serum BDNF concentration was increased compared with the control group at T4 and T5 (<0.001).

Conclusion

RIPC could reduce the incidence of POCD in elderly patients after laparoscopic cholecystectomy.

MeSH

Cholecystectomy, Laparoscopic, Aged, Serum, Ischemic Preconditioning, Brain-Derived Neurotrophic Factor, Cognitive Dysfunction, Postoperative Cognitive Complications

Cited by

• Effect of remote ischemic preconditioning on perioperative neurocognitive disorder in elderly patients undergoing major surgery and associated genetic variant analysis: a randomized clinical trial. Perioper Med (Lond), 2025
• Value of narcotrend anesthesia depth monitoring in predicting POCD in gastrointestinal tumor anesthesia block patients. BMC Anesthesiol, 2024