Postoperative Cognitive Dysfunction
Conditions
Interventions
S-ketamine group:0.2mg/kg/h Esketamine
Dexmedetomidine group:0.5ug/kg/h Dexmedetomidine
Sponsors
Guiyang Fourth People’s Hospital
Eligibility
Sex/Gender
All
Age
60 Years to 80 Years
Inclusion criteria
Inclusion criteria: 1.Age: 60 to 80 years old; 2.American Society of Anesthesiologists (ASA) Physical Status Classification: Class I to III; 3.Body Mass Index (BMI) in kg/m²: 18 to 30; 4.Patients scheduled for unilateral total hip replacement surgery; 5.Meeting the diagnostic criteria for malnutrition according to the Global Leadership Initiative on Malnutrition (GLIM); 6.Preoperative assessment using the Montreal Cognitive Assessment (MOCA) scale: inclusion if the score is 26 or above; 7.Have signed an informed consent form.
Exclusion criteria
Exclusion criteria: 1. Patients with mental illnesses. 2. Patients at severe risk of elevated blood pressure or intracranial pressure. 3. Patients with high intraocular pressure, glaucoma, or penetrating eye trauma. 4. Patients with poorly controlled or untreated hypertension, with resting systolic/diastolic blood pressure exceeding 180/110 mmHg. 5. Patients with untreated or inadequately treated hyperthyroidism. 6. Patients allergic to ketamine, propofol, or opioids. 7. Patients with unstable ischemic heart disease. 8. Individuals with combined heart failure (NYHA heart function classification >= Grade 3), history of stroke, severe liver disease (such as liver failure), or chronic renal failure (glomerular filtration rate < 30 mL/min). 9. Preoperative patients with Parkinson's disease and/or Alzheimer's disease, combined with anxiety, depression, and emotional disorders. 10. Individuals with a history of cerebrovascular accidents or long-term use of medications affecting the nervous and psychiatric systems. 11. Those who have participated in other trials.
Design outcomes
Primary
| Measure | Time frame |
|---|---|
| The incidence of POCD within 3 days after surgery.;The types and quantities of intestinal flora in patients before surgery (1 day prior) and after the first postoperative bowel movement.; | — |
Secondary
| Measure | Time frame |
|---|---|
| Numeric Rating Scale (NRS).;Anesthesia time;The incidence of postoperative nausea and vomiting (PONV).;Antibiotic type and dosage;Psychiatric symptoms within 3 days after surgery;Surgery time;Recovery room stay time; | — |
Countries
China
Contacts
Public ContactQianglin Yi
Guiyang Fourth People’s Hospital
Outcome results
None listed