Electroencephalogram, Postoperative Delirium, Sevoflurane
Conditions
Brief summary
Delirium is an acute onset of attentional and cognitive impairment. BIS guided anesthesia can reduce the incidence of postoperative delirium. Long term electroencephalogram (EEG) suppression during operation is related to postoperative delirium. The latest research shows that the anesthesia depth guided by EEG does not reduce the incidence of postoperative delirium. The purpose of this study was to explore the relationship between anesthesia exposure with different minimum alveolar concentration(MAC) and postoperative delirium(POD), and to observe the characteristics of EEG.
Detailed description
More and more studies have focused on the relationship between EEG inhibition and postoperative delirium in general anesthesia. At present, there are two kinds of commonly processed quantitative EEG monitoring to evaluate the depth of anesthesia, one is bispectral index (BIS) and the other is patient state index (PSI). The relationship between intraoperative anesthetic exposure and postoperative delirium is unclear, or whether potential patient characteristics increase the risk of EEG suppression and postoperative delirium. Gastrointestinal surgery can lead to long-term changes in colonic flora, which can remotely regulate brain function through the gut brain axis. We speculated that the abnormal composition of intestinal flora before abdominal operation might be the influencing factor of POD.
Interventions
DRUGLow MAC
To maintain a target of sevoflurane inhalation concentration 0.8 MAC.
DRUGHigh MAC
To maintain a target of sevoflurane inhalation concentration 1.0 MAC.
Sponsors
The First Affiliated Hospital of Anhui Medical University
Study design
Allocation
RANDOMIZED
Intervention model
PARALLEL
Primary purpose
TREATMENT
Masking
TRIPLE (Subject, Investigator, Outcomes Assessor)
Eligibility
Sex/Gender
ALL
Age
60 Years to 90 Years
Healthy volunteers
No
Inclusion criteria
* Clinical diagnosis of gastrointestinal diseases * Patients were aged 60 to 90 years * American Society of Anesthesiologists (ASA) risk classification II-IV * Patients were scheduled to undergo elective major abdominal operation(with a anticipated time of 2-6 h)
Exclusion criteria
* Preoperative dementia or cognitive impairment * Mental instability or mental illness * Patients with any factors affecting cognitive assessment, such as language, vision and hearing impairment * Any cerebrovascular accident occurred within 3 months, such as stroke etc * Previous history of delirium * Known hypersensitivity to sevoflurane or history of malignant hyperthermia * Abuse of narcotic sedative and analgesic drugs * Those who have reoperation within 7 days after operation
Design outcomes
Primary
| Measure | Time frame | Description |
|---|---|---|
| Incidence of POD | The 1st day after the surgery | Incidence of POD after surgery |
Secondary
| Measure | Time frame | Description |
|---|---|---|
| EEG burst inhibition | During surgery | Frequency of EEG burst inhibition |
| Incidence of adverse events | 30-day after surgery | Incidence of adverse events after surgery |
| length of stay | From 1st day after the surgery to 2 weeks | length of stay after surgery |
| 30-day mortality | 30-day after surgery | 30-day mortality after surgery |
Countries
China
Outcome results
None listed