| Project/Area Number |
16591564
|
|---|
| Research Category |
Grant-in-Aid for Scientific Research (C)
|
| Allocation Type | Single-year Grants |
|---|
| Section | 一般 |
|---|
| Research Field |
Anesthesiology/Resuscitation studies
|
|---|
| Research Institution | Yokohama City University (2006)
Teikyo University (2004-2005) |
|---|
Principal Investigator |
GOTO Takahisa Yokohama City University, Graduate School of Medicine, Professor, 医学研究科, 教授 (00256075)
|
|---|
| Co-Investigator(Kenkyū-buntansha) |
ISHIGURO Yoshiki Teikyo University, School of Medicine, Professor, 医学部, 教授 (40232285)
TAKADA Shinji Teikyo University, School of Medicine, Assistant Professor, 医学部, 講師 (90226788)
SAKAMOTO Hidetoshi Teikyo University, School of Medicine, Instructor, 医学部, 助手 (90349267)
MORITA Shigeho Teikyo University, School of Medicine, Professor, 医学部, 教授 (60143476)
花田 諭史 帝京大学, 医学部, 助手 (10365976)
|
|---|
| Project Period (FY) |
2004 – 2006
|
| Project Status |
Completed (Fiscal Year 2006)
|
| Budget Amount *help |
¥3,400,000 (Direct Cost: ¥3,400,000)
Fiscal Year 2006: ¥700,000 (Direct Cost: ¥700,000)
Fiscal Year 2005: ¥1,000,000 (Direct Cost: ¥1,000,000)
Fiscal Year 2004: ¥1,700,000 (Direct Cost: ¥1,700,000)
|
|---|
| Keywords | Xenon / Cognitive Decline / NMDA receptor / 手術 / 麻酔 |
|---|
| Research Abstract |
We investigated the effects of two general anesthetics with N-methyl-D-aspartate (NMDA) receptor blocking properties, ketamine and xenon, postoperative cognitive decline in 65 patients who were older than 60 and underwent major abdominal or orthopedic surgeries. Anesthesia consisted of (1) nitrous oxide and sevoflurane (control group, n=21), (2) nitrous oxide and sevoflurane plus a continuous infusion of ketamine at 511g・kg-1・mind (ketamine group, n=22) or (3) xenon 60% plus sevoflurane (xenon group, n=22). Cognitive function was evaluated by using the Mini-Mental State Examination and the Symbol-Digit Substitution and the Digit-Span subsets of the revised Wechsler Adult Intelligence tests (WAIS-R). Cognitive function was I evaluated preoperatively, 2weeks after surgery, and 6 months after surgery. Cognitive decline was predefined as the worsening of the score of any test of greater than 20% compared to the preoperative value. Furthermore, the plasma level of S-100b protein, the biomarker of cerebral injury, was measured preoperatively, at the end of operation, and 48 hours postoperatively.
At two weeks postoperatively, the number of patients who demonstrated cognitive decline was 6/21 (control), 7/22 (ketamine), and 4/22 (xenon). The difference was not statistically significant. At 6 months postoperatively, the number was 3/17 (control), 4/20 (ketamine), and 2/18 (xenon). The plasma level of 5-100b protein was not different among the three anesthetic groups.
In conclusion, neither ketamine nor xenon had therapeautic effects on the postoperative congnitive dysfunction in the elderly surgical patients. However, the number of the patients enrolled was too small to draw any definite conclusions.
|
