Perioperative neurocognitive disorders and acute lung injury
Conditions
Interventions
Esketamine group:In the esketamine group, 0.25mg/kg esketamine was given during anesthesia induction, and 0.2mg/kg/h of esketamine was continuously injected intravenously after endotracheal intubation
Control group:The control group was given equal volume of normal saline at the induction and maintenance of anesthesia, and stopped 30 minutes before the end of the operation.
Sponsors
Tianjin Union Medical Center
Eligibility
Sex/Gender
All
Age
18 Years to No maximum
Inclusion criteria
Inclusion criteria: 1. Elective laparoscopic surgery is planned, and the duration of pneumoperitoneum is expected to be >=3h; 2. Pneumoperitoneum pressure reaches IAH standard (>=12 mmHg); 3. Age>=18 years old, male or female; 4. American Society of Anesthesiologists (ASA) grade I~III; 5. No history of esketamine allergy; 6. Voluntarily sign the informed consent form.
Exclusion criteria
Exclusion criteria: 1. Patients with BMI 30kg/m^2; 2. Patients at risk of severe elevated blood pressure or intracranial pressure; 3. Patients with poorly controlled or untreated hypertension, such as systolic blood pressure (SBP) > 180 mmHg or diastolic blood pressure (DBP) > 110 mmHg, heart rate (HR) > 120 beats/min; 4. Patients with neuropsychiatric diseases, neurocognitive disorders and poor compliance before surgery; 5. Abnormal liver and kidney function: abnormal liver function is defined as aspartate aminotransferase (AST) and/or alanine aminotransferase (ALT) levels exceeding 1.5 times the upper limit of normal (ULN), and renal function abnormalities are defined as serum creatinine (Cr) >=1.5 times ULN; 6. Patients with abnormal preoperative chest CT and arterial blood gas analysis results; 7. History of drug abuse; 8. Those who participate in other studies at the same time, or who have not signed the informed consent form.
Design outcomes
Primary
| Measure | Time frame |
|---|---|
| Incidence of delayed neurocognitive recovery;Chest CT imaging changes; | — |
Secondary
| Measure | Time frame |
|---|---|
| Incidence of postoperative delirium;Levels of markers of intestinal barrier damage in the blood;Levels of markers of nerve damage in the blood;Arterial blood oxygenation level;Ventilation/blood flow ratio;Exhaled nitric oxide levels;Levels of intestinal bacteria metabolites in the blood;Levels of markers of lung injury in the blood ;Postoperative pain score; | — |
Countries
China
Contacts
Public ContactZhao Tingting
Tianjin Union Medical Center
Outcome results
None listed