The relationship between the perioperative transition of serum anticholinergic activity and postoperative delirium among patients undergoing esophagectomy and gastrectomy

Research Project

Project/Area Number	23791353
Research Category	Grant-in-Aid for Young Scientists (B)
Allocation Type	Multi-year Fund
Research Field	Psychiatric science
Research Institution	Juntendo University
Principal Investigator	HARA Atsuko 順天堂大学, 医学部, 助教 (00330861)
Project Period (FY)	2011 – 2013
Project Status	Completed (Fiscal Year 2013)
Budget Amount *help	¥3,640,000 (Direct Cost: ¥2,800,000、Indirect Cost: ¥840,000) Fiscal Year 2013: ¥1,430,000 (Direct Cost: ¥1,100,000、Indirect Cost: ¥330,000) Fiscal Year 2012: ¥650,000 (Direct Cost: ¥500,000、Indirect Cost: ¥150,000) Fiscal Year 2011: ¥1,560,000 (Direct Cost: ¥1,200,000、Indirect Cost: ¥360,000)
Keywords	術後せん妄 / 抗コリン活性 / 手術侵襲 / 炎症 / せん妄 / 高齢者 / 血清抗コリン活性 / 食道癌手術 / 胃切除術 / サイトカイン / 血清コリン活性 / I型インスリン様増殖因子
Research Abstract	We evaluated the changes in the levels of serum anticholinergic activity (SAA) during the pre- and postoperative periods, and investigated the relationship between the levels of SAA and the occurrence of postoperative delirium. Patients undergoing elective esophagectomy or gastrectomy under general anesthesia were prospectively studied. The levels of SAA were measured immediately before and after the surgery, then categorized into three groups, (+), () and (-) according to the results.Postoperative delirium was identified in 41.2% of the 34 patients enrolled in this study. The preoperatively SAA (+) patients who remained SAA (+) or SAA () after surgery were more likely to develop postoperative delirium. It was speculated that the cholinergic system failed to compensate for the elevation of the SAA level in patients who developed delirium. In conclusion, the perioperative transition of the SAA levels may be associated with the occurrence of postoperative delirium.