Perioperative neurocognitive disorders
Conditions
Interventions
The group of esketamine:Administer esketamine at a dose of 0.25 mg/kg for induction, and 0.125 mg/kg?h for anesthesia maintenance and stop 30 minutes before the end of the surgery
The group of dexmedetomidine:pump 0.2 µ g/kg dexmedetomidine 10 minutes before anesthesia induction, at a dose of 0.2 µ g/kg?h for anesthesia maintenance and stop 30 minutes before the end of the surg
Sponsors
The First Affiliated Hospital of Guangxi Medical University;
Sichuan Cancer Hospital
Eligibility
Sex/Gender
All
Age
65 Years to No maximum
Inclusion criteria
Inclusion criteria: 1.Elderly patients (>= 65 years old) undergoing elective pulmonary surgery under general anesthesia; 2.American Society of Anesthesiology (ASA) physical status I–III; 3.Body mass index (BMI) 18–30kg/m2
Exclusion criteria
Exclusion criteria: 1. Preoperative cognitive impairment in Minimental State Examination (MMSE) (preoperative score <=17 (illiterate), <=20 (primary school), <=22 (secondary school), <=24 (high school and above); 2. History of cardiac surgery, cerebrovascular accident and alcohol abuse; 3. The presence of serious organic diseases, such as liver and kidney dysfunction; 4. Coagulation disorders; 5. Severe visual and hearing impairment, obstructing communication and communication disorders; 6. History of mental illness or long-term sedative or depressive medications, neurodegenerative diseases (Alzheimer's disease and Parkinson's disease); 7. Intracranial hypertension; 8. Severe uncontrolled hypertension; 9. Glaucoma; 10. Admission to ICU due to severe postoperative complications; 11. Reoperation; 12. Loss to follow-up; 13. Patients with a history of acetylcholine use; 14. Severe respiratory diseases (respiratory failure, severe chronic obstructive pulmonary disease); 15. Patients with contraindications to esmketamine and dexmedetomidine; 16. Patients with severe subcutaneous emphysema, serious adverse events (such as intraoperative bleeding and severe hemodynamic fluctuations); 17. Emergency surgery; (r) Decision to withdraw from the study during the study period; 18. Hyperthyroidism; (t) sinus bradycardia (heart rate (HR) <50 beats/min), sick sinus syndrome, or second degree atrioventricular block or greater.
Design outcomes
Primary
| Measure | Time frame |
|---|---|
| Postoperative delirium; | — |
Secondary
| Measure | Time frame |
|---|---|
| Biomarkers:Nfl,Il-6,Aß,PF4; | — |
Countries
China
Contacts
Public ContactYubo Xie
The First Affiliated Hospital of Guangxi Medical University; Sichuan Cancer Hospital
Outcome results
None listed