Perioperative Neurocognitive Disorders
Conditions
Interventions
Control Group:Participants in the control group will receive standard general anesthesia management without dexmedetomidine administration and without transcutaneous auricular vagus nerve stimulation
Dexmedetomidine Group:Participants in this group will receive continuous intravenous infusion of dexmedetomidine after anesthesia induction at a rate of 0.4–0.6 µg/kg/h without a loading dose, maintai
Dexmedetomidine + taVNS Group:Participants in this group will receive dexmedetomidine infusion according to the same protocol as Group B, combined with transcutaneous auricular vagus nerve stimulation
Sponsors
Affiliated Hospital of West Anhui Health Vocational College
Eligibility
Sex/Gender
All
Age
65 Years to 85 Years
Inclusion criteria
Inclusion criteria: 1. Age >= 65 years, regardless of sex; 2. American Society of Anesthesiologists (ASA) physical status II–III; 3. Patients scheduled to undergo elective orthopedic, abdominal, or thoracoscopic surgery under general anesthesia; 4. Able to complete baseline cognitive assessment preoperatively and cooperate with postoperative follow-up and questionnaire assessments; 5. The patient and their family members voluntarily agree to participate in the study and provide written informed consent.
Exclusion criteria
Exclusion criteria: 1. A clear diagnosis of moderate to severe dementia or severe cognitive impairment in the past (if MoCA is lower than the preset threshold, the threshold is determined according to the actual situation of the center and the version of the scale); 2. Frequent strokes, epileptic seizures or other serious central nervous system diseases within the past three months have prevented the assessment from being completed; 3. Severe mental disorders (such as schizophrenia, manic episodes) or the use of strong sedative/antipsychotic drugs that affect the reliability of assessment and cannot be discontinued; 4. Severe visual/hearing impairment or language communication disorders prevent the completion of cognitive tests; 5. Clearly identify allergies or contraindications to dexmedetomidine; There are significant bradycardia/high-grade atrioventricular block (without pacemaker implantation), refractory hypotension and other conditions that are not suitable for the use of dexmedetomidine; 6. Contraindications or inapplicability of taVNS: auricular skin infection/ulcer/severe eczema, recent ear surgery or deformity affecting electrode placement; Implantable electronic devices (such as pacemakers/defibrillators) and evaluated as unsuitable for nerve electrical stimulation; 7. Those who are expected to require long-term sedation/mechanical ventilation after surgery and are unable to complete the assessment of PND/ delirium as planned; 8. Other circumstances that the researcher deems unsuitable for enrollment.
Design outcomes
Primary
| Measure | Time frame |
|---|---|
| Postoperative Neurocognitive Dysfunction (PND) incidence rate (defined as a decline of >=2 points in MoCA score from baseline); | — |
Secondary
| Measure | Time frame |
|---|---|
| Postoperative delirium incidence rate;Changes in inflammatory markers (IL-6, TNF-a, CRP);Quality of Recovery (QoR-40) score;Length of hospital stay;Dynamic cognitive function assessment via WeChat mini-program (reaction time, digit span, etc.); | — |
Countries
China
Contacts
Public ContactShen Jun
Affiliated Hospital of West Anhui Health Vocational College
Outcome results
None listed