Sevoflurane, Propofol and Desflurane on POD/POCD
Kulcsszavak
Absztrakt
Leírás
Postoperative delirium (POD) and postoperative cognitive disorder (POCD) are the most common complications of geriatric surgical patients, which could cause long-term social dysfunction, high mortality and increased medical cost. Currently, there is no efficient biomarker for POD/POCD, and it also remains largely unknown whether different anesthesia might lead to different incidence and severity of POD/POCD. The investigator's previous studies showed that thickness of retinal nerve fiber layer thickness (RNFL-T) measured by optical coherence tomography (OCT) was associated with POD/POCD; change of RNFL thickness (RNFL-C) in certain period correlated with cognitive deterioration. Thus, the investigators consider that RNFL might be a potential biomarker of POD/POCD. In the proposed large-scale longitudinal studies, the investigators will clinically validate RNF-LT as pre-operative POD/POCD biomarker, and RNFL-C as post-operative biomarker of POD/POCD. Finally, the investigators will compare the effects of surgery (total hip/knee replacement) under general anesthesia with sevoflurane, propofol and desflurane on the incidence and severity of POD/POCD in patients. Results from the proposed studies will likely establish RNFL as a potential POD/POCD biomarker, promote the clinical utilization of OCT-RNFL in early screening and outcome prediction of POD/POCD, and finally optimize anesthesia care of geriatric surgical patients to avoid or reduce POD/POCD incidence. These findings will lead to better postoperative outcomes of geriatric patients.
Dátumok
Utolsó ellenőrzés: | 04/30/2019 |
Első benyújtás: | 10/05/2017 |
Becsült beiratkozás benyújtva: | 10/29/2017 |
Első közzététel: | 10/30/2017 |
Utolsó frissítés beküldve: | 05/26/2019 |
Utolsó frissítés közzétéve: | 05/28/2019 |
A tanulmány tényleges kezdési dátuma: | 12/31/2015 |
Becsült elsődleges befejezési dátum: | 06/29/2021 |
A tanulmány becsült befejezési dátuma: | 06/29/2021 |
Állapot vagy betegség
Beavatkozás / kezelés
Drug: Sevoflurane
Drug: Propofol
Drug: Desflurane
Fázis
Karcsoportok
Kar | Beavatkozás / kezelés |
---|---|
Sevoflurane Patients in Sevoflurane group are maintained with sevoflurane from an anesthesia machine through the laryngeal mask airway guided by Narcrotrend index monitoring. | Drug: Sevoflurane Anesthesia maintenance with sevoflurane guided by Narcrotrend index monitoring. |
Propofol Patients in Propofol group are maintained with propofol through intravenous administration guided by Narcrotrend index monitoring. | Drug: Propofol Anesthesia maintenance with propofol guided by Narcrotrend index monitoring. |
Desflurane Patients in Desflurane group are maintained with desflurane from an anesthesia machine through the laryngeal mask airway guided by Narcrotrend index monitoring. | Drug: Desflurane Anesthesia maintenance with desflurane guided by Narcrotrend index monitoring. |
Jogosultsági kritériumok
Tanulásra alkalmas korok | 60 Years Nak nek 60 Years |
Tanulásra alkalmas nemek | All |
Mintavételi módszer | Non-Probability Sample |
Egészséges önkénteseket fogad | Igen |
Kritériumok | Inclusion Criteria: - 60 years old or older - Chinese Mandarin as the native language - scheduled to undergo hip/knee surgery under general anesthesia - American Society of Anesthesiologists (ASA) class I-Ⅲ Exclusion Criteria: - Prior diagnoses of neurological diseases according to ICD-10 - History of severe psychiatric disorders according to DSM-IV - Visual or auditory defects - Participating in the investigation of another study |
Eredmény
Elsődleges eredménymérők
1. Postoperative delirium [At 1st day after the surgery]
Másodlagos eredménymérők
1. Postoperative delirium [At 2nd day after the surgery]
2. Postoperative delirium [At 3rd day after the surgery]
3. Preoperative cognitive function [Preoperative cognitive function (baseline)]
4. Postoperative cognitive dysfunction [Change from baseline cognitive dysfunction at 1 week]
5. Postoperative cognitive dysfunction [Change from baseline cognitive dysfunction at 3rd month]
6. Retinal nerve fiber layer thickness [Change from baseline RNFL thickness at 3rd month]
7. Serum level of vitamin B12, folic acid, homocysteine and myeloid differentiation protein-2 (MD-2s) [Before the surgery (baseline)]
8. Serum level of vitamin B12, folic acid, homocysteine and myeloid differentiation protein-2 (MD-2s) [At 1st day after the surgery]
9. Serum level of vitamin B12, folic acid, homocysteine and myeloid differentiation protein-2 (MD-2s) [At 2nd day after the surgery]
10. Serum level of vitamin B12, folic acid, homocysteine and myeloid differentiation protein-2 (MD-2s) [At 3rd day after the surgery]