Elderly trauma
Conditions
Interventions
Dexmedetomidine TCI Group (DEX Group): :Target effect-site concentration (Ce) set at 0.4–0.6 ng/ml.
Remimazolam TCI Group (REM Group):Target plasma concentration (Cp) set at 0.5–0.8 µg/ml
Biofeedback Relaxation Group (BIO Group):Receive 5 minutes of standardized training (abdominal breathing + muscle relaxation) before surgery
Control Group (CTRL Group):TCI pump loaded with sterile saline
Sponsors
Affiliated Chenggong Hospital of Xiamen University (73rd Army Group Hospital)
Eligibility
Sex/Gender
All
Age
65 Years to No maximum
Inclusion criteria
Inclusion criteria: 1. Age >= 65 years. 2. Lower extremity trauma with a Lower Extremity Trauma Score (LETS) >= 4 (indicating moderate to severe injury). 3. Anesthesia method: combined spinal anesthesia and peripheral nerve block.
Exclusion criteria
Exclusion criteria: 1. Contraindications to MRI (e.g., presence of metallic implants, claustrophobia, etc.); 2. Severe baseline cognitive impairment (Montreal Cognitive Assessment, MoCA score < 18); 3. Severe liver or kidney dysfunction (Child-Pugh class C or estimated glomerular filtration rate [eGFR] < 30 ml/min/1.73 m^2); 4. Long-term use of sedatives, analgesics, or psychotropic drugs (e.g., benzodiazepines, opioids); 5. Hemodynamic instability requiring high-dose vasoactive agents for maintenance; 6. Contraindications to neuraxial anesthesia.
Design outcomes
Primary
| Measure | Time frame |
|---|---|
| Changes in Brain Region Activation (fMRI Z-Scores); | — |
Secondary
| Measure | Time frame |
|---|---|
| Visual Analog Scale;Neuroendocrine and Immune Stress Indicators:Cortisol,Epinephrine,Norepinephrine; | — |
Countries
China
Contacts
Public ContactPengxia Wang
Affiliated Chenggong Hospital of Xiamen University(The 73rd Army Group Hospital, PLA)
Outcome results
None listed