الفهرس 
INTRODUCTIONOnly 14 pages are availabe for public view
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Abstract
This study was a prospective randomized comparative clinical trial. That took place at Suez Canal University Hospital in the scheduled operating theatres. Our study aimed to improve the outcome of patients undergoing on-pump CABG through reducing post-operative cognitive dysfunction
After obtaining approval of the Research Ethics Committee of the Faculty of Medicine, Suez Canal University, and a signed written informed patient consent, patients were recruited and randomly assigned into one of two equal groups on alternative basis each group include 20 patients group1 received remote ischemic preconditioning (RIPC).group 2 received standard intraoperative management (not receive RIPC).we exclude patients who have previously documented cognitive deficits, cerebrovascular accident. (detected by positive past history &by applying Mini-Mental State Examination, patients with upper extremity vascular disease or claudication, and planned harvest of the radial artery for conduit use during CABG, Patients with hepatic impairment (Child score B or Child score C), patients with chronic renal insufficiency, patients on medications altering cognitive functions as pregabalin, CABG redo surgery, patients with carotid atherosclerosis (by carotid Doppler ultrasound).
Anesthetic protocol and surgical technique were similar in both groups. RIPC group received 4 cycles of brief (5minutes) left upper extremity ischemia by inflating a tourniquet to 100 mmHg over systolic blood pressure interspersed with 5-minute periods of reperfusion during which the tourniquet was deflated. Repetitive brief occlusion and reperfusion were completed before aortic cannulation and initiation of cardiopulmonary bypass. In group
Summary
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2 Standard intraoperative management (control) a tourniquet that remains deflated was placed on left upper extremity of all selected patients.