Perioperative neurocognitive disorders (PND) refer to changes in cognitive abilities such as orientation, thinking, memory, attention, and self-awareness that occur in patients during the perioperative period. Based on the timing of onset, PND can be divided into four subcategories: preoperative cognitive impairment, postoperative delirium (POD), delayed neurocognitive recovery (DNR), and postoper
Conditions
Interventions
Nerve Block Combined with Superficial General Anesthesia Group:Patients in this group will undergo surgery under nerve block combined with light general anesthesia
Lumbar Epidural Combined Anesthesia Group:Patients in this group will undergo surgery under lumbar epidural combined anesthesia
Sponsors
Shenzhen Second People's Hospital
Eligibility
Sex/Gender
All
Age
65 Years to 90 Years
Inclusion criteria
Inclusion criteria: 1.Participants voluntarily agree to join the study and sign an informed consent form; 2.Age >= 65 years; 3.Undergoing unilateral orthopedic joint replacement surgery (hip or knee); 4.Expected anesthesia duration exceeds 2 hours;
Exclusion criteria
Exclusion criteria: 1.Individuals with severe central nervous system disorders or psychological conditions that cannot comply with assessment scales (e.g., speech impairment due to post-stroke sequelae, inability to write, etc.); 2.Individuals with severe visual or auditory impairments, as well as color blindness or color weakness; 3.Individuals with alcohol or drug dependence; 4.Individuals with serious medical conditions, such as severe liver dysfunction (Child-Pugh classification C), severe kidney dysfunction (uremia requiring replacement therapy), or ASA classification IV; 5.Contraindications for spinal anesthesia or nerve block, including severe coagulopathy, infection at the puncture site, lumbar spine fracture, or allergy to local anesthetics; 6.Individuals consenting to MRI examinations must be screened for contraindications, such as claustrophobia, the presence of a cardiac pacemaker, patients who have undergone artificial valve replacement, individuals with ferromagnetic vascular clips in their body, or those with metallic foreign bodies in the eye;
Design outcomes
Primary
| Measure | Time frame |
|---|---|
| The incidence of PND one week after surgery; | — |
Secondary
| Measure | Time frame |
|---|---|
| Mortality rate within one year postoperatively;One-year event-free survival rate postoperatively;The cognitive function assessment results one year post-surgery;Total length of hospital stay;The number of patients admitted to the ICU postoperatively.;The incidence of complications within one month postoperatively;The incidence of postoperative concealed intracranial stroke;One month postoperatively; | — |
Countries
China
Contacts
Public ContactZhiheng Liu
Shenzhen Second People's Hospital
Outcome results
None listed