Postoperative delirium
Conditions
Interventions
The propofol group (Group P):1. Anesthesia induction: Propofol at 1.0-1.5mg/kg, sufentanil at 0.5-1µg/kg, and rocuronium at 0.6mg/kg are used.
2. Anesthesia maintenance: Propofol 3-10mg/kg/h, cisatrac
The remimazolam group (Group R):1.Anesthesia induction: Remimazolam 0.2-0.3mg/kg (injection time >=30 seconds), sufentanil 0.5-1µg/kg, rocuronium 0.6mg/kg were used
2.Anesthesia maintenance: Remimazolam 0.5-2.0mg/kg/h, cisatracurium 0.1-0.2mg/kg/h
3.During ICU stay: Continuous intravenous infusion of remimazolam (0.1-0.3mg/kg/h)
Sponsors
Zhongda Hospital Affiliated to Southeast University
Eligibility
Sex/Gender
All
Age
65 Years to No maximum
Inclusion criteria
Inclusion criteria: 1. Patients scheduled for their first cardiac valve surgery under CPB; 2. Age >= 65 years old, gender not limited; 3. Classified as grade II-IV by the American Society of Anesthesiologists (ASA); 4. It has been reviewed and approved by the ethics committee of this hospital, and an informed consent form has been signed with the patient or their family.
Exclusion criteria
Exclusion criteria: 1. Preoperative cognitive impairment: The Mini-Mental State Examination (MMSE) score was used: illiterate <=17 points, primary school <=20 points, junior high school and above <=24 points; 2. Patients with a history of severe mental disorders (such as depression, bipolar disorder, schizophrenia, etc.) 3. Previous history of neurosurgery, obvious neurological diseases such as epilepsy, Parkinson's disease or dementia; 4. There was severe liver and kidney failure before the operation (Child-Pugh grade C, or serum creatinine clearance rate <30ml/min, or renal replacement therapy was required); 5. Preoperative respiratory failure dependent on mechanical ventilation; 6. Allergic to remimazolam or propofol; 7. Unable to communicate due to severe visual, auditory or language impairments; 8. Patients with myasthenia gravis; 9. Patients undergoing major vascular surgery who require deep hypothermic circulatory arrest.
Design outcomes
Primary
| Measure | Time frame |
|---|---|
| the incidence of delirium within the first 7 postoperative days; | — |
Secondary
| Measure | Time frame |
|---|---|
| Incidence of hypotension after induction;Postoperative recovery parameters: duration of mechanical ventilation (h), length of stay in the ICU (h), total length of stay (days), postoperative nausea and vomiting;Delirium duration;Adverse events related to sedative drugs;30 day all-cause mortality;Other complications;NRS scores at 24 and 48 hours after operation;Subtype of delirium;The changes of inflammatory factors such as IL-6 and IL-1ß and the biomarker S100ß in serology before and 24 hours after the operation;Cumulative EEG burst suppression time;The patient recovered quality 7 days after the operation; | — |
Countries
China
Contacts
Public ContactYao Juan
Zhongda Hospital Affiliated to Southeast University
Outcome results
None listed