Hematology and Oncology Research Center, Tabriz University of Medical Sciences, Tabriz, Iran.
Departments of Pharmacotherapy, Faculty of Pharmacy, Tehran University of Medical Sciences, Tehran, Iran.
Daru. 2017 Nov 21;25(1):24. doi: 10.1186/s40199-017-0190-0.
Post-operative cognitive dysfunction (POCD) is an important complication of cardiac surgeries. Glutamate plays a critical role in physiologic and pathologic conditions in the brain. Due to the role of glutamate in ischemia, this study is designed to identify the effect of memantine in prevention of POCD early and late after cardiac surgeries.
In this randomized clinical trial, 172 patients with ages 45-75 years old who underwent elective cardiac surgery were enrolled. For patients in memantine group, 5 mg of memantine per day administered at least 48 h before surgery and increased to 10 mg per day during the first 24 h after surgery and continued for 3 months. A brief Wechsler memory test (WMT) was administered before, three to 5 days after, and 3 months after surgery for both groups.
Both groups demonstrate standard pattern of cognitive dysfunction after surgery and in follow up. Pre- and post-operative WMT score showed significant improvement in memantine compared to control group (P < 0.001) both in unadjusted and adjusted with confounding factor analysis. Unadjusted pre-, post-operative, and follow up WMT score improved significantly after 3 months in memantine group (P = 0.006).
Pre-operative administration of memantine protects patients from POCD following cardiac surgeries. In addition, it improves cognitive function 3 months after surgery.
The trial was registered in the Iranian Registry of Clinical Trials (registration number: IRCT201303168698N12 ). Memantin effect on POCD.
术后认知功能障碍（POCD）是心脏手术的一个重要并发症。谷氨酸在大脑的生理和病理条件中起着关键作用。由于谷氨酸在缺血中的作用，本研究旨在确定美金刚在心脏手术后早期和晚期预防 POCD 的效果。
在这项随机临床试验中，纳入了 172 名年龄在 45-75 岁之间的择期心脏手术患者。对于美金刚组的患者，在手术前至少 48 小时给予每天 5 毫克美金刚，并在手术后 24 小时内增加到每天 10 毫克，持续 3 个月。两组患者均在术前、术后 3-5 天和 3 个月进行简短韦氏记忆测验（WMT）。
两组患者在手术后和随访中均表现出认知功能障碍的标准模式。与对照组相比，美金刚组的 WMT 评分在未调整和调整混杂因素分析后均有显著改善（P<0.001）。在未调整、术后和随访中，美金刚组在 3 个月后 WMT 评分显著改善（P=0.006）。
术前给予美金刚可预防心脏手术后发生 POCD。此外，它还可以改善手术后 3 个月的认知功能。
该试验在伊朗临床试验注册中心（注册号：IRCT201303168698N12）注册。美金刚对 POCD 的影响。
