Increased intracranial pressure
Conditions
Interventions
Hypertonic saline group:When the head was lowered for 30 minutes during the surgical operation, 4ml/kg of 3% hypertonic saline solution was rapidly intravenously infused into the HS group within 30 mi
Saline group:When the head was lowered for 30 minutes during the surgical operation, the NS group was instilled with 4ml/kg 0.9% isotonic saline solution within the same period of time.
Sponsors
The First Affiliated Hospital of Nanjing Medical University
Eligibility
Sex/Gender
All
Age
45 Years to 80 Years
Inclusion criteria
Inclusion criteria: Middle aged and elderly patients (45-80 years old) who choose to undergo robot assisted prostate cancer and bladder cancer surgery; ASA classification levels I-III; Heart function NYHA classification I-II, ejection fraction EF>=50%; BMI0.30; Can complete the Mini Mental State Examination (MMSE) score before surgery.
Exclusion criteria
Exclusion criteria: Patients who refused to be enrolled; Patients with contraindications for hypertonic saline infusion: hypernatremia (preoperative blood sodium concentration > 150mmol/l), severe renal insufficiency, severe cardiac insufficiency (NYHA grade III-IV for cardiac function, ejection fraction EF<50%), coagulation disorders, phlebitis, etc. Combined with severe cardiovascular and cerebrovascular system diseases; Chronic obstructive pulmonary disease Severe liver dysfunction; Severe electrolyte imbalance; Patients with difficult airways; Has previously taken sedatives, antidepressants or anti-anxiety drugs; Has a history of drug or alcohol dependence; Have severe visual and hearing impairments; There was a lack of good cognitive function before the operation (if the patient's educational level was junior high school or higher, the MMSE score was < 24;) If the patient's years of education are less than 6 years, the MMSE score is less than 20. If the patient is illiterate, the MMSE score is less than 17. Patients who have received neoadjuvant chemotherapy; Patients whose heads are in a low position for more than 4 hours during surgery
Design outcomes
Primary
| Measure | Time frame |
|---|---|
| Changes in the diameter of the optic nerve sheath; | — |
Secondary
| Measure | Time frame |
|---|---|
| Riker sedation-agitation score during the recovery period;Incidence of delirium;MMSE Scale;Regional cerebral oxygen saturation;Changes of serological biomarkers :S-100ß; BDNF before and after the operation;The incidence of adverse reactions such as postoperative eye pain, blurred vision, dizziness and headache, nausea and vomiting, and bulbar conjunctival edema in patients;Monitor the changes of arterial blood gas in the two groups of patients after they entered the room and during the operation; | — |
Countries
China
Contacts
Public ContactLiu Cunming
Jiangsu Provincial People's Hospital
Outcome results
None listed