Postoperative Delirium
Conditions
Keywords
processed EEG, Postoperative vulnerability, Older people, Brain vulnerability
Brief summary
An assessment of difference in prespecified processed electroencephalography variables between cognitively intact older surgical patients who develop postoperative delirium compared to those who do not develop postoperative delirium
Detailed description
Postoperative delirium in older people may be contributed to by intrinsic brain vulnerability such as pre-existing dementia. Some cognitively intact older people also experience postoperative delirium and in these patients some go on to develop later dementia. The investigators propose that postoperative delirium may be an unmasking of covert brain vulnerability by the dyshomeostasis of the anaesthesia/surgical intervention. In people with dementia or mild cognitive impairment, electroencephalography (EEG) studies have shown slowing of brain wave activity, especially in the back of the brain. Processed electroencephalography, using a limited number of channels, is routinely used during anaesthesia to aid assessment of anaesthetic depth of the patient. In this study the investigators will assess the feasibility of acquiring EEG data from the front and back of the brain. The investigators will also explore the data for early signals of brain vulnerability
Interventions
OTHERProcessed electroencephalography
Acquisition of raw EEG data from processed EEG monitor. Analysis of data acquired for prespecified bandwidth properties
OTHERPostoperative delirium assessment
Twice daily assessment for the incidence of postoperative delirium using validated tool (questionnaire)
Sponsors
University of Nottingham
Study design
Observational model
COHORT
Time perspective
PROSPECTIVE
Eligibility
Sex/Gender
ALL
Age
65 Years to No maximum
Healthy volunteers
No
Inclusion criteria
* ≥ 65 years old * Elective, moderate/major, non-neuro, non-cardiac surgery * Ability to give informed consent
Exclusion criteria
* Preoperative cognitive impairment * Current systemic infection * Current use of medication that may modify EEG * History of neurosurgery/significant head trauma * Presence of neurological diseases including overt stroke, dementia, epilepsy, multiple sclerosis, Parkinson's disease, intracranial tumours and other significant neurologic disorders * Current significant psychiatric conditions such as severe depression. * Palliative surgery
Design outcomes
Primary
| Measure | Time frame | Description |
|---|---|---|
| Feasibility of acquiring frontal and posterior EEG data from the Narcotrend monitor during the preoperative and intraoperative period | Approximately 1 - 2 hours per participant | Feasibility will be assessed by the ability to get preoperative and intraoperative epochs of EEG that clearly demonstrates the different brain wave bands (alpha, theta and delta) |
Secondary
| Measure | Time frame | Description |
|---|---|---|
| Preoperative brain wave differences | Approximately 10 minutes per participant | Identify any differences in frontal and posterior narrowband (i.e. alpha, delta and theta) power preoperatively between older people who develop POD compared to those who do not. |
| Change in brain wave power due to induction of anaesthesia | Approximately 1 hour per particpant | Identify if the change in narrowband power from the preoperative values to steady state intraoperative values are different between groups (i.e. people who develop POD vs people who do not develop POD) |
| Intraoperative brain wave patterns | Duration of surgery or 2 hours (shortest option) | Identify any differences in mean and spectral edge frequencies preoperatively and intraoperatively between older people who develop POD and those who do not. |
Countries
United Kingdom
Outcome results
None listed