Postoperative Cognitive Dysfunction
Conditions
Keywords
Sevoflurane, Propofol, Cardiac valvular surgery, Cardiopulmonary bypass, Postoperative cognitive dysfunction
Brief summary
As the investigators know, postoperative cognitive dysfunction (POCD) is a fairly well-documented clinical phenomenon, which affect patients' short-term and long-term outcome. Most patients will receive general anesthesia and cardiopulmonary bypass (CPB) during cardiac valvular surgery. Inhalation sevoflurane based and propofol based anesthesia are most commonly used strategy for general anesthesia. At present, it was unknown that which one is better in providing cerebral protection effect for patients undergoing cardiac valvular surgery with CPB. The current study aimed to explore the possible difference.
Detailed description
The investigators hypothesize that the incidence of postoperative cognitive dysfunction (POCD) is not different in patients received intravenous anesthetics propofol or sevoflurane for their cardiac valvular surgery. Two groups of general anesthetics (propofol or sevoflurane) are used to explore the possible difference of the postoperative outcome and the incidence of POCD. After cardiac valvular surgery with CPB, patients' POCD tests at 7 days after the surgery, and postoperative delirium, etc., are evaluated by different questionnaires. Also the blood sample of these patients are collected for detection of some stress hormones.
Interventions
DRUGsevoflurane
DRUGpropofol
Sponsors
Xinqiao Hospital of Chongqing
Study design
Allocation
RANDOMIZED
Intervention model
PARALLEL
Primary purpose
PREVENTION
Masking
QUADRUPLE (Subject, Caregiver, Investigator, Outcomes Assessor)
Eligibility
Sex/Gender
ALL
Age
18 Years to 65 Years
Healthy volunteers
Yes
Inclusion criteria
* patients who receive cardiac valvular surgery * 18 to 65 years * American society of anesthesiologists classification Ⅱto Ⅲ * education level higher than elementary school
Exclusion criteria
* Patients are not expected to be alive for longer than 3 months. * Mini-mental State Examination (MMSE) score ≤ 23. * current use of sedatives or antidepressant * history of dementia, psychiatric illness or any diseases of central nervous system. * accompanying liver or kidney function deficiency * history of some endocrine disease * alcoholism and drug dependence * patients previously included in this study or currently included in the other clinical study * patients who have second surgery during the study period * difficult to follow up or patients with poor compliance
Design outcomes
Primary
| Measure | Time frame | Description |
|---|---|---|
| Number of patients with postoperative cognitive dysfunction (POCD) | From 7 days after the surgery to the day of discharge from hospital | POCD is a composite outcome measure |
Secondary
| Measure | Time frame | Description |
|---|---|---|
| Postoperative delirium (POD) | Up to 7 days after the surgery | POD is evaluated by a commonly used questionnaire |
Other
| Measure | Time frame | Description |
|---|---|---|
| Degree of increase of stress hormones | Up to 24 hours after the surgery | Stress hormones include S-100β, Il-6, etc. |
| Length of ICU stay | Up to 7 days after the surgery | The time for patient stay in ICU |
| Length of hospital stay | Up to 3 months after the surgery | The time for patient stay in hospital |
Countries
China
Outcome results
None listed