Postoperative Neurocognitive Disorder
Conditions
Interventions
Experimental group:Dexmedetomidine
Sponsors
The First People's Hospital of Zunyi
Eligibility
Sex/Gender
All
Age
65 Years to No maximum
Inclusion criteria
Inclusion criteria: 1.Aged >= 65 years; 2.ASA physical status ?-?; 3.Elective total knee arthroplasty under general anesthesia; 4.With operation duration between 1 hour and 3 hours; 5.Preoperative MMSE score >= 24 points; 6.No alcohol or drug dependence; 7.No psychiatric disorders; 8.Capable of completing postoperative follow-up and assessments; 9.Able to cooperate with eye-movement test and scale evaluation; 10.Informed consent obtained from patients and their families.
Exclusion criteria
Exclusion criteria: 1.MMSE score 24 points; 2.Confirmed dementia, Parkinson’s disease, history of psychiatric diseases, organic lesions of the central nervous system; 3.Severe audiovisual impairment precluding examinations (hearing/language disorders, illiteracy, organic ocular lesions, inability to complete neuropsychological scale assessment); 4.Severe hepatic or renal failure, cardiac insufficiency; 5.Abnormal coagulation function; 6.longterm use of sedatives or antipsychotic drugs; 7.Emergency surgery; 8.Operation duration 1 h or 3 h; 9.Anticipated massive intraoperative hemorrhage (20 % of blood volume); 10.Incomplete clinical data;Subjects withdrawing from the study midway.
Design outcomes
Primary
| Measure | Time frame |
|---|---|
| Incidence of postoperative cognitive dysfunction at 24 h postoperatively assessed by MMSE scale; | — |
Secondary
| Measure | Time frame |
|---|---|
| Montreal Cognitive Assessment (MoCA) score;Generalized Anxiety Disorder-7 (GAD-7) score;Brief Pain Inventory-Short Form (BPI-SF) score;Bilateral prefrontal regional cerebral oxygen saturation (rSO2);Number of cases and duration of cerebral oxygen desaturation events;Serum concentrations of IL-6, TNF-a, sTREM2 and NfL;Intraoperative vital signs (blood pressure, heart rate, pulse oxygen saturation);Eye movement parameters of prosaccade, antisaccade and memory-guided saccade tasks; | — |
Countries
China
Contacts
Public ContactJinqing Tang
The First People's Hospital of Zunyi
Outcome results
None listed