Postoperative Cognitive Dysfunction
Conditions
Keywords
Dexmedetomidine,postoperative cognitive dysfunction
Brief summary
The purpose of this study is to identify the effects of different doses of dexmedetomidine on postoperative cognitive dysfunction in elderly hypertensive patients
Interventions
DRUGdexmedetomidine
Experimental: Group A, Continuous pump infusion dexmedetomidine with loading dose at 0.8µg.kg-1 over 10 minutes,followed continuous pump infusion dexmedetomidine at 0.3µg.kg-1.h-1 until 30 minutes before end of operation
DRUGnormal saline
Group C , Normal saline infusion will be given with the same infusion volume as group A and B
DRUGmidazolam,fentanyl,etomidate,Cisatracurium besylate
Anesthesia induction : 0.05 mg.kg-1 midazolam,4\ 5μg.kg-1 fentanyl,1.0\ 1.5mg.kg-1etomidate and 0.15 mg.kg-1Cisatracurium besylate
DRUGcisatracurium besylate,propofol,remifentanil,sevoflurane
Maintenance of anesthesia :Continuous pump infusion 0.05\ 0.1mg.kg-1.h-1cisatracurium besylate,4\ 8mg.kg-1.h-1propofol,0.1\ 0.2μg.kg-1.min-1 remifentanil and sevoflurane inhalation with 0.6%\ 1.0%
Sponsors
First Affiliated Hospital Xi'an Jiaotong University
Study design
Allocation
RANDOMIZED
Intervention model
PARALLEL
Primary purpose
TREATMENT
Masking
DOUBLE (Subject, Investigator)
Eligibility
Sex/Gender
ALL
Age
65 Years to 80 Years
Healthy volunteers
No
Inclusion criteria
* Written informed consent * Elective gastrointestinal surgery * American Society of Anesthesiologists class II to III * Aged between 65 and 80 years old * Weight between 45 and 75 kilogram,Body Mass Index between 19 and 24 kg.m-2 * With primary hypertension reaching or more than 1 year * Normal cognitive function,mini-mental state examination more than 27
Exclusion criteria
* Severe arrhythmia,atrioventricular block and secondary hypertension * Liver and kidney dysfunction,pulmonary disease,endocrine disease * Suspected or confirmed difficult airway * Any disease or pathologic change will interfere study result * Inability to exchange with serious visual and hearing impairment * Long term use of sedative-hypnotic drugs and antidepressant drug * Addicted to alcohol, tobacco or drug * Neuromuscular disease * Suspected of malignant hyperthermia * Allergic to investigational products or with other contraindication * Participated in other study within 30 days
Design outcomes
Primary
| Measure | Time frame | Description |
|---|---|---|
| Change from baseline to postoperation in depression scale | One day before operation,third day after operation,sixth day after operation | Beck Depression Inventory |
| Change from baseline to postoperation in recent memory | One day before operation,third day after operation,sixth day after operation | Rey Auditory Verbal Learning Test |
| Change from baseline to postoperation in visual space and directional force | One day before operation,third day after operation,sixth day after operaion | Trail Making Test A,Trail Making Test B |
| Change from baseline to postoperation in attention | One day before operation,third day after operation,sixth day after operaion | Digit Span Test |
| Change from baseline to postoperation in pain scores | One day before operation,third day after operation,sixth day after operation | Visual analog scales |
| Change from baseline to postoperation in cognitive function | One day before operation,third day after operation,sixth day after operaion | Mini-mental State Examination |
Secondary
| Measure | Time frame | Description |
|---|---|---|
| The blood volume during the operation | From begining of cutting skin to the end of skin closure,an expected average of 3 hours | — |
| The urine volume during operation | From begining of cutting skin to the end of skin closure,an expected average of 3 hours | — |
| The dose of drugs used during operation | From begining of cutting skin to the end of skin closure,an expected average of 3 hours | The dose of ephedrine, urapidil, atropine used during operation |
| The duration of operation | From begining of cutting skin to the end of skin closure,an expected average of 3 hours | — |
Outcome results
None listed