Pupil Contraction Rate, Pupil Diameter, Pupil Light Reflection
Conditions
Keywords
Pupil, Cognitive Dysfunction, recovery
Brief summary
The pupil diameter is affected by both sympathetic and parasympathetic nerves, and its latency and response amplitude mainly reflect the functional status of the parasympathetic nerve. Clinically, the diagnosis of neurological diseases can often be made based on changes in pupils. An appropriate depth of anesthesia can cause minimal damage to the body after surgery, thereby reducing the impact on brain function and cognitive function. The occurrence of postoperative delirium will have adverse effects on the prognosis of patients, such as prolonging the hospital stay, increasing the mortality of patients after surgery, and increasing early postoperative cognitive dysfunction.
Interventions
PROCEDUREpupil's light and pupil diameter
It is necessary to meet the requirement that the pupil's light reflection is slightly restored to the state of entering the room, and then the tube is extubated and the pupil diameter and the light reflection are restored to the state of entering the room, leaving the recovery room
Sponsors
Yangzhou University
Study design
Allocation
RANDOMIZED
Intervention model
PARALLEL
Primary purpose
SUPPORTIVE_CARE
Masking
TRIPLE (Subject, Investigator, Outcomes Assessor)
Eligibility
Sex/Gender
ALL
Age
65 Years to 95 Years
Healthy volunteers
No
Inclusion criteria
* Elderly patients undergoing general anesthesia for tracheal intubation, aged ≥65 years, operation time ≥2 hours, ASA classification I-III, and postoperative hospital stay for at least one week.
Exclusion criteria
1. It is known that this study involves persons who are allergic to general anesthetics; 2. Patients with previous eye diseases; 3. Head and neck surgery is not conducive to measurement; 4. Patients with preoperative MMSE score less than 24 points or dementia due to various diseases; 5. Patients planning to undergo neurosurgery; 6. Those who use sedatives or antipsychotics before surgery; 7. Patients with known central nervous system diseases, such as mental illness; Patients with hearing or vision impairment and unable to communicate normally.
Design outcomes
Primary
| Measure | Time frame | Description |
|---|---|---|
| Changes in the level of pupil diameter | before surgery, the time of intubation, the time of extubation, 1min,3minafter intubation, 10min,20min, 30min after extubation, the reflection of light appears1,2,3,7 day after surgery | — |
| Changes in the level of Mini-Men-tal State Examination scale score | The day before surgery and 1,2,3,7 days after surgery | Assess the cognitive function of the patient by asking questions on the patient scale.A score of 27 to 30 indicates normal cognitive function, and a score below 27 indicates cognitive dysfunction. |
| Changes in the level of Pittsburgh sleep quality index | The day before surgery and 1,2,3,7 days | Assess the patient's sleep quality by asking questions on the scale.The lower the score, the more serious the sleep disorder. |
| Changes in the level of pupil light reflection | before surgery, the time of intubation, the time of extubation, 1min,3minafter intubation, 10min,20min, 30min after extubation, the reflection of light appears1,2,3,7 day after surgery | — |
| Changes in the level of Polysomnography | before surgery, the time of intubation, the time of extubation, 1min,3min after intubation, 10min,20min, 30min after extubation, the reflection of light appears1,2,3,7 day after surgery | Through the polysomnograph, monitor the patient's sleep during anesthesia, including brain wave changes and sleep stages at different time points |
| Changes in the level of CAM-ICU scale score | 1,2,3,7 days after surgery | First, evaluate the patient's state of consciousness based on the patient's behavior, and decide whether to proceed with the next evaluation based on the state of consciousness. If the next step is to be evaluated, ask the patient related questions to score, and evaluate whether the patient has delirium based on the score.The lower the score, the more likely the patient is to suffer from delirium. questions to score, and evaluate whether the patient has delirium based on the score. with the next evaluation based on the state of consciousness. If the next step is to be evaluated, ask the patient related questions to score, and evaluate whether the patient has delirium based on the score. |
Secondary
| Measure | Time frame | Description |
|---|---|---|
| Changes in the level of Heart Rate | before surgery, the time of intubation, the time of extubation, 1min,3min after intubation, 10min,20min, 30min after extubation, the reflection of light appears | — |
| Changes in the level of Systolic Blood Pressure/Diastolic Blood Pressure(Mean Arterial Pressure) | before surgery, the time of intubation, the time of extubation, 1min,3min after intubation, 10min,20min, 30min after extubation, the reflection of light appears | — |
| Changes in the level of Oxygen saturation | before surgery, the time of intubation, the time of extubation, 1min,3min after intubation, 10min,20min, 30min after extubation, the reflection of light appears | — |
| Changes in the waveform of Narcotrend | before surgery, the time of intubation, the time of extubation, 1min,3min after intubation, 10min,20min, 30min after extubation, the reflection of light appears | The outcome above should be measured at the time Before induction, immediately before intubation, immediately after intubation, at the beginning of the operation, 1 hour after the beginning of the operation, and immediately after extubation at the end of the operation |
Countries
China
Outcome results
None listed