Effect Of Perioperative Extract Of Ginkgo Biloba On Postoperative Cognitive Dysfunction After Non-Acadiac Surgery In Elderly Patients

Objective:To investigate the effect of perioperative extract of ginkgo biloba on postoperative cognitive dysfunction after non-cardiac surgery in elderly patients.Methods:55physical status Ⅱ-Ⅲ,aged over70years weighing52-78kg undergoing selective non-cardiac surgery under general anesthesia were randomly divided into two groups:group Y (n=30) and group C (n=25).patients in group Y were received oral premedication with ginkgo biloba19.2mg, tid, last for3days, then received20ml injection of ginkgo biloba for3days (injection were diluted into0.9%saline in patients with DM). Patients in group C were received oral premedication with placebo for3days, and received0.9%saline infusion after surgery. Two groups were intravenous patient controlled analgesia (PCA) constantly until48h after operation. MMSE(mini-mental state examination) scores were recorded before(T0),1(T1) and7(T2) days after operation, respectively. Blood serum concentration of IL-6、TNF-α were measured before and24h after operation. Results:Cognitive deficit was present in4(13.3%) group Y and in10(40%) group C at1day after operation. There was no significant difference between group Y and group C (P>0.05) Cognitive deficit was in2(6.7%) group Y and in8(16%) group C at7day after operation, and no significant difference between two groups. In patients with DM, there are significant difference in incidence of POCD at T1between group Y and group C.MMSE scores at T1were lower than those at T0in both groups. There were not significant differences in MMSE scores between group Y and group C (P>0.05). In Patients with DM, there was significant difference in MMSE scores between T1and T0in both groups (P<0.05), and at T1there was significant difference in MMSE scores between group Y and group C (P<0.05).There were significant increase in the level of IL-6and TNF-α in both groups comparing with the level before anesthesia(P<0.05). TNF-α in control group increased significantly compared with group Y at postoperative time point (P<0.05). In patients with DM, there were significant in the level of IL-6and TNF-α in both groups, IL-6、 TNF-α in control group increased significantly compared with group Y.Conclusion:Perioperative medication of extract of ginkgo biloba can improve postoperative cognitive function after non-cardiac surgery in elderly, in particular for patients with type2diabetes mellitus. The mechanism may related to reduce the inflammatory cytokines.