Neurocognitive Dysfunction
Conditions
Interventions
Esketamine group:During induction, administer a bolus of esketamine at 0.25 mg/kg, followed by a continuous infusion of esketamine at 0.125 mg/kg/h until 1 hour before the end of the surgery.
Control group:Administer an equal dose of saline solution at the same time point.
Sponsors
Yantai Yuhuangding Hospital
Eligibility
Sex/Gender
All
Age
35 Years to 80 Years
Inclusion criteria
Inclusion criteria: 1. Persons aged 35-80 years who meet the diagnostic criteria for metabolic syndrome, ASA grade I-III., patients undergoing major abdominal surgery, operation time > 2h, and informed consent of patients. International Diabetes Federation (IDF) criteria need to be met: The IDF criteria emphasize the centrality of abdominal obesity and need to meet at least three of the following five criteria: (1) Abdominal obesity (i.e., central obesity): waist circumference >=90 cm for men and 80 cm >= for women. A BMI of >30 can be used instead. (2) Hyperglycemia: fasting blood glucose = 6.1 mmol/L or blood glucose >= 7.8mmol/L 2 h after glucose load and/or those who have been diagnosed with diabetes mellitus and treated. (3) Hypertension: blood pressure >= 130/85 mmHg (1 mmHg=0.133 kPa) and/or those who have been confirmed to be hypertension and treated. (4) Fasting triglycerides (TG) >= 1.70mmol/L. (5) Fasting HDL C<1.04mmol/L.
Exclusion criteria
Exclusion criteria: 1.Patients with central nervous system diseases, mental disorders or psychological disorders before surgery had a Mini-Mental State Examination (MMSE) score of <24 points and a Delirium Observation Scale (DOS) score of =3 points. 2.Patients with known intolerance to esketamine, lack of cooperation, or impaired communication abilities (e.g., language barriers, autism, aphasia, coma, terminal illness, or drug/alcohol abuse). 3.Patients with severe liver or kidney dysfunction; 4.Patients with secondary factors affecting metabolism, such as hyperthyroidism. 5.Patients with severe hypertension and cardiovascular or cerebrovascular diseases. 6.Patients with hearing or visual impairments that hinder normal communication. 7.Patients with unsatisfactory surgical outcomes who require immediate secondary surgery.
Design outcomes
Secondary
| Measure | Time frame |
|---|---|
| MAP;HR;BIS;Major Adverse Cardiovascular Events;Surgical time;Duration of anesthesia;Volume of blood loss;Propofol and remifentanil consumption;Total volume of crystalloids and colloids;Vasoactive drug administration;Sufentanil rescue analgesia;The QoR-15 score; | — |
Primary
| Measure | Time frame |
|---|---|
| Incidence rate of DNR;Mini-Mental State Examination Score;Postoperative delirium incidence; | — |
Countries
China
Contacts
Public ContactMa Jiahai
Yantai Yuhuangding Hospital
Outcome results
None listed