Effect of remote ischemic preconditioning on postoperative cognitive dysfunction in adult patients with general anesthesia: a meta-analysis

Abstract

Abstract Background Remote ischemic preconditioning (RIPC) is proven to have neuroprotective protective effects. Nevertheless, the impact of RIPC on postoperative cognitive dysfunction (POCD) in patients undergoing general anesthesia is controversial. This meta-analysis of randomized controlled trials (RCTs) aimed to assess the effect of RIPC on POCD in adults after general anesthesia. Methods Relevant literature was obtained by searching Embase, PubMed, Web of Science, Cochrane Library, Wanfang, and China National Knowledge Infrastructure (CNKI) databases in July 2022. RCTs were included to assess the influences of RIPC on POCD in adults following general anesthesia. Two investigators independently performed literature screening, data extraction, and quality assessment based on the inclusion and exclusion criteria. The incidence of POCD, operation time, and hospital stay were analyzed by Review manager5.4 software. Results Thirteen RCTs with 1122 participants were selected for this meta-analysis. Compared to the control group, RIPC decreased the incidence of POCD (OR = 0.50, 95% CI 0.31–0.82), as well as reduced the duration of hospitalization (MD = − 0.98, 95% CI − 1.69 to − 0.27), but did not prolong operative time (MD = − 2.65, 95% CI − 7.68 to 2.37). Conclusion RIPC reduced the incidence of POCD in adult patients after general anesthesia and accelerated their discharge.

Keywords

• General surgery
• General anesthesia
• Remote ischemic preconditioning
• Postoperative complications
• Cognitive dysfunction
• Neuropsychological tests