Colorectal cancer
Conditions
Interventions
Permissive hypercapnia:Ventilation parameters: Tidal volume 6 ~ 8mL/kg, Respiratory rate 12 ~ 14 bpm, Suction/Respiration ratio 1:2, PaC02 45 ~ 55mmHg, pH >. 7.2,PEEP 0 cmH2O, FiO2 40%
Conventional ventilation:Ventilation parameters: Tidal volume10 ~ 12mL/kg, Respiratory rate 14 ~ 16 bpm, Suction/Respiration ratio 1:2, PaCO2 35 ~ 45mmHg,PEEP 0 cmH2O, FiO2 40%
Sponsors
Shengjing Hospital of China Medical University
Eligibility
Sex/Gender
All
Age
65 Years to 90 Years
Inclusion criteria
Inclusion criteria: ? ASA I-III; ? Age = 65 years old; ? BMI 18-28 kg/m2; ? Preoperative MMSE score =23; ? Conscious and able to think independently; ? Laparoscopic colorectal cancer surgery is planned, with no contraindications; ? Fragile brain function in non-acute stage (history of cerebral hemorrhage, cerebral infarction, TIA, craniocerebral vascular stenosis, PD, long-term headache and dizziness, no attack within three months and no corresponding clinical symptoms); ? Consent to participate in the trial
Exclusion criteria
Exclusion criteria: ? Patients with intracranial hypertension (hydrocephalus, brain tumor, brain space occupying lesions, etc.); ? The forehead has a history of surgery, trauma or skin lesions, infected; ? Patients with a history of severe depression, schizophrenia or other psychiatric disorders or who have taken antipsychotic or antidepressant drugs; ? Patients with severe audio-visual impairment and unable to communicate normally; ? Patients with severe underlying diseases (such as acute coronary syndrome, severe arrhythmia, heart failure, liver and kidney failure, etc.) except hypertension, diabetes, COPD and fragile brain function-related diseases defined in the inclusion criteria; ? Preoperative moderate to severe anemia patients (Hb < 90 g/L); ? Preoperative arterial oxygen partial pressure < 70 mmHg; ? Patients who underwent laparoscopic colorectal surgery again within 7 days; ? Patients undergoing emergency surgery or undergoing open operation due to unexpected circumstances; ? Patients who have participated in other clinical studies that may affect the outcome of this study.
Design outcomes
Primary
| Measure | Time frame |
|---|---|
| Absolute change in rSO2 from baseline (T0) to surgical completion (T4) in groups H and N.; | — |
Secondary
| Measure | Time frame |
|---|---|
| Cerebral oxygen metabolism related indexes at T1, T2, T3 and T4 during surgery: rSO2, Da-jvO2 ml/L, CERO2 % (T1: 15 minutes after endotracheal intubation; T2: 60 min after pneumoperitoneum; T3: 120 min after pneumoperitoneum; T4: Suture completed, surgery completed);MMSE score and incidence of DNR 1 day before surgery and 1, 3 and 7 days after surgery;;Serum neuron-specific enolase (NSE) and interleukin-6 (IL-6) levels 1 day before and 1 day after surgery;;Incidence of intraoperative cerebral deoxygenation events (CDE): relative decrease of cerebral oxygen saturation from base value =20% or absolute value of rSO2 =55%;Anesthesia recovery time;Incidence of postoperative ICU admission events;30 days postoperative all-cause mortality;Incidence of postoperative pulmonary complications;The hospitalization duration;The incidence of postoperative adverse events (nausea, vomiting, hypotension, bradycardia, excessive sedation); | — |
Countries
China
Contacts
Public ContactJun Chai
Outcome results
None listed