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Effect of intranasal insulin on perioperative cognitive function in older adults: a randomized, placebo-controlled, double-blind clinical trial.
Sun, Miao; Ruan, Xianghan; Zhou, Zhikang; Huo, Yuting; Liu, Min; Liu, Siyuan; Cao, Jiangbei; Liu, Yan-Hong; Zhang, Xiaoying; Ma, Yu-Long; Mi, Weidong.
Afiliación
  • Sun M; Department of Anesthesiology, The First Medical Center of Chinese PLA General Hospital, Beijing 100730, China.
  • Ruan X; Department of Anesthesiology, The First Affiliated Hospital, Jinzhou Medical University, Jinzhou, Liaoning Province, China.
  • Zhou Z; Department of Anesthesiology, The First Medical Center of Chinese PLA General Hospital, Beijing 100730, China.
  • Huo Y; Department of Anesthesiology, The First Medical Center of Chinese PLA General Hospital, Beijing 100730, China.
  • Liu M; Department of Anesthesiology, The First Medical Center of Chinese PLA General Hospital, Beijing 100730, China.
  • Liu S; Department of Anesthesiology, Beijing Tongren Hospital, Capital Medical University, Beijing, China.
  • Cao J; Department of Anesthesiology, The First Medical Center of Chinese PLA General Hospital, Beijing 100730, China.
  • Liu YH; Department of Anesthesiology, The First Medical Center of Chinese PLA General Hospital, Beijing 100730, China.
  • Zhang X; Department of Anesthesiology, The First Medical Center of Chinese PLA General Hospital, Beijing 100730, China.
  • Ma YL; Department of Anesthesiology, The First Medical Center of Chinese PLA General Hospital, Beijing 100730, China.
  • Mi W; Department of Anesthesiology, The First Medical Center of Chinese PLA General Hospital, Beijing 100730, China.
Age Ageing ; 53(9)2024 Sep 01.
Article en En | MEDLINE | ID: mdl-39216470
ABSTRACT

BACKGROUND:

Postoperative cognitive impairment are common neural complications in older surgical patients and exacerbate the burden of medical care on families and society.

METHODS:

A total of 140 older patients who were scheduled for elective orthopaedic surgery or pancreatic surgery with general anaesthesia were randomly assigned to Group S or Group I with a 11 allocation. Patients in Group S and Group I received intranasal administration of 400 µL of normal saline or 40 IU/400 µL of insulin, respectively, once daily from 5 minutes before anaesthesia induction until 3 days postoperatively. Perioperative cognitive function was assessed using the Mini-Mental State Examination (MMSE) and Montreal Cognitive Assessment-Basic (MoCA-B) at 1 day before and 3 days after surgery and postoperative delirium (POD) incidence was assessed using the 3-minute Diagnostic Interview for CAM (3D-CAM) on postoperative days 1-3. Serum levels of interleukin-6 (IL-6), tumour necrosis factor α (TNF-α), S100-ß and C-reactive protein (CRP) were measured on the first day after surgery.

RESULTS:

Insulin treatment significantly increased postoperative MMSE and MoCA-B scores in group I than in group S (P < 0.001, P = 0.001, respectively), decreased the incidence of POD within the 3-day postoperative period in Group I than in Group S (10.9% vs 26.6%, P = 0.024), and inhibited postoperative IL-6 and S100-ß levels in Group I compared to Group S (P = 0.034, P = 0.044, respectively).

CONCLUSIONS:

Intranasal insulin administration is thus suggested as a potential therapy to improve postoperative cognition in older patients undergoing surgery. However, a more standardized multi-centre, large-sample study is needed to further validate these results.
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Texto completo: 1 Colección: 01-internacional Base de datos: MEDLINE Asunto principal: Administración Intranasal / Cognición / Complicaciones Cognitivas Postoperatorias / Insulina Límite: Aged / Aged80 / Female / Humans / Male Idioma: En Revista: Age Ageing Año: 2024 Tipo del documento: Article País de afiliación: China Pais de publicación: Reino Unido
Texto completo
Añadir a Mi BVS
Imprimir
XML
PubMed Links
Buscar en Google

Texto completo: 1 Colección: 01-internacional Base de datos: MEDLINE Asunto principal: Administración Intranasal / Cognición / Complicaciones Cognitivas Postoperatorias / Insulina Límite: Aged / Aged80 / Female / Humans / Male Idioma: En Revista: Age Ageing Año: 2024 Tipo del documento: Article País de afiliación: China Pais de publicación: Reino Unido