The Neuroprotective Effects of RPC on the Neurosurgery

Air Force Military Medical University of People's Liberation Army

Status and phase: Completed; Phase 1

Conditions: s100b

Treatments: Procedure: remote preconditioning

Study type: Interventional

Funder types: Other

Identifiers

NCT00866489

DONG2008RPC

Details and patient eligibility

About

The current study is designed to clarify the neuroprotective effect of remote ischemic precondtioning on the patients underwent neurosurgery.

Full description

BACKGROUND: Brain ischemia and injury are commonly contributed to perioperative morbidity and mortality after neurosurgery. Remote ischemic preconditioning (RIPC) is a phenomenon whereby brief periods of ischemia followed by reperfusion in one organ provide systemic protection from prolonged ischemia. To investigate whether remote preconditioning protects the brain injury in patients undergoing elective neurosurgery, a randomized trial will be performed in current study.

DESIGNING Thirty patients undergoing craniotomy for supratentorial meningioma will be randomize assigned to neurosurgery with RIPC or conventional neurosurgery (control). Remote ischemic preconditioning consist of three 5-min cycles of right upper limb ischaemia, induced by an automated cuff-inflator placed on the upper arm and inflated to 200 mm Hg, with an intervening 5 min of reperfusion during which the cuff is deflated. Cerebral injury was assessed by S-100b, NSE, and neurological function scores in different time points.

EXPECTED RESULTS RIPC will reduce the incidence of cerebral injury.

CONCLUSIONS:

In patients undergoing elective craniotomy for supratentorial meningioma, RIPC reduces the incidence of postoperative cerebral injury.

Enrollment: 70 patients

Sex: All

Ages: 20 to 70 years old

Volunteers: No Healthy Volunteers

Inclusion criteria

• Patients referred for primary elective neurosurgery were invited to participate in the study at the time of scheduling for operation

Exclusion criteria

• Potential participants were excluded if they were >70 years of age
• Required concomitant procedures other than neurosurgery
• Had experienced an acute coronary syndrome or myocardial infraction within 3 months
• Were unable to give informed consent
• Were taking sulfonylurea oral hypoglycemic agents or nicorandil drug therapy because these agents have been shown to effect preconditioning.

Trial design

Primary purpose: Prevention

Allocation: Randomized

Interventional model: Parallel Assignment

Masking: Quadruple Blind

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70 participants in 2 patient groups

sham RIPC

No Intervention group

Description:

Patients had a deflated cuff placed on the right upper arm for 30 min.

RIPC

Experimental group

Description:

RIPC consisted of three 5-min cycles of right upper arm ischemia, which was induced by an automated cuff-inflator placed on the right upper arm and inflated to 200 mmHg, with an intervening 5 min of reperfusion during which the cuff was deflated

Treatment:

Procedure: remote preconditioning