Key result
Remote ischemic preconditioning maintains stable troponin after orthopedic surgery but fails to prevent postoperative delirium.
Why the study?
Although large randomized trials in non-cardiac surgery have not demonstrated convincing clinical benefits of remote ischemic preconditioning, individual studies suggest potential value.
Does remote ischemic preconditioning prevent myocardial injury and postoperative delirium in a high-risk geriatric patient undergoing orthopedic surgery?
Case Report (n=1)
Does remote ischemic preconditioning prevent myocardial injury and postoperative delirium in a high-risk geriatric patient undergoing orthopedic surgery?
In a high-risk cardiac patient, RIPC prior to non-cardiac surgery was associated with stable postoperative troponin levels but did not prevent a transient episode of delirium, highlighting the need for further controlled studies.
Remote ischemic preconditioning may be feasible without myocardial injury in high-risk noncardiac surgery; leaves open delirium prevention and requires RCTs before any practice consideration.
Remote ischemic preconditioning (RIPC) is considered a method for reducing ischemia-reperfusion injury during surgical interventions. Although large randomized trials in non-cardiac surgery have not demonstrated convincing clinical benefits, individual studies may suggest their potential value. We present a case report of a female patient undergoing elective orthopedic surgery, in whom RIPC was performed immediately after the induction of anesthesia. Postoperatively, troponin I levels remained within normal limits on days 1, 2, and 3, with no clinical or electrocardiographic signs of myocardial injury. A transient episode of delirium was noted on the first postoperative day; however, after treatment, the patient's condition quickly recovered, and she remained oriented and communicative. Renal function remained stable. This clinical case illustrates the clinical use of RIPC in a high-risk cardiac patient. The observed stable troponin levels and favorable postoperative course are consistent with the hypothesis of a possible protective effect of RIPC. However, these observations are descriptive in nature and highlight the need for further prospective studies to evaluate the potential effectiveness of this technique and identify patient groups that may benefit most from it.
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Shayakhanov et al. (2026) conducted a case report in High-risk cardiac patient undergoing orthopedic surgery (n=1). Remote ischemic preconditioning was evaluated on Myocardial injury (troponin I levels) and postoperative delirium. Remote ischemic preconditioning in a high-risk 65-year-old female undergoing orthopedic surgery resulted in stable postoperative troponin levels but did not prevent a transient episode of delirium.
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