Neurocognitive Disorders, Inhalation; Vapor
Conditions
Brief summary
This study aims to investigate the effect of inhaled anesthetics with a low fresh gas flow on cognitive function of elderly patients undergoing elective surgery
Detailed description
Geriatric patients scheduled to undergo surgery were tested with Mini Mental State Examination (MMSE) in the preoperative visit. MMSE was repeated postoperatively at the 6th hour, the 1st, 3rd, and 7th day. Visual analogue scale (VAS) test was performed simultaneously on the postoperative 6th hour, the 1st, 3rd, and 7th day. Two cohorts were created according to the amount of fresh gas flow (low flow vs high flow) in the maintenance phase of the inhalational anesthetic. MMSE scores were compared between cohorts and baseline. VAS scores were compared between cohorts.
Interventions
General anesthesia with a fresh gas flow lower than 1L/min for the maintenance phase of anesthesia
General anesthesia with a fresh gas flow equal to or higher than 1L/min for the maintenance phase of anesthesia
6 category and 30-point test to inquire patient's cognitive function
The patient's self-reported pain intensity according to a visual scale between 0 and 100
Sponsors
Study design
Eligibility
Inclusion criteria
* Age\>65 * Consenting to participate * Scheduled for surgery longer than 2 hours under GA * Able to read and write
Exclusion criteria
* Age\<65 * Refusing to participate * Existing visual impairment preventing the patient from reading or writing * Unable to read and write * Existing major neurocognitive disorder * Use of TIVA or regional techniques * Allergies to the volatile agents * Uncontrolled DM, acute alcohol intoxication * Conditions increasing tissue oxygen consumption (sepsis, thyrotoxicosis, etc.) * Anticipation/existence of major hemorrhage * Haemodynamic instability \> 10 min or more than 5 times intraoperatively
Design outcomes
Primary
| Measure | Time frame | Description |
|---|---|---|
| Change from baseline in neurocognitive status on the 30 point MMSE at postoperative 24th hour | Baseline and postoperative day 1 | A Mini-Mental State Examination (MMSE) is a set of 11 questions that doctors and other healthcare professionals commonly use to check for cognitive impairment (problems with thinking, communication, understanding and memory). |
Secondary
| Measure | Time frame | Description |
|---|---|---|
| Change from baseline in neurocognitive status on the 30 point MMSE at postoperative 3rd day | Baseline and postoperative day 3 | A Mini-Mental State Examination (MMSE) is a set of 11 questions that doctors and other healthcare professionals commonly use to check for cognitive impairment (problems with thinking, communication, understanding and memory). |
| Change from baseline in neurocognitive status on the 30 point MMSE at postoperative 7th day | Baseline and postoperative day 7 | A Mini-Mental State Examination (MMSE) is a set of 11 questions that doctors and other healthcare professionals commonly use to check for cognitive impairment (problems with thinking, communication, understanding and memory). |
| Change from baseline in pain on the 10 point VAS scale at postoperative 6th hour | Baseline and postoperative hour 6 | The visual analog scale (VAS) is a tool widely used to measure pain. A patient is asked to indicate his/her perceived pain intensity (most commonly) along a 100 mm horizontal line, and this rating is then measured from the left edge |
| Change from baseline in neurocognitive status on the 30 point MMSE at postoperative 6th hour | Baseline and postoperative hour 6 | A Mini-Mental State Examination (MMSE) is a set of 11 questions that doctors and other healthcare professionals commonly use to check for cognitive impairment (problems with thinking, communication, understanding and memory). |
| Change from baseline in pain on the 10 point VAS scale at postoperative 24th hour | Baseline and postoperative hour 24 | The visual analog scale (VAS) is a tool widely used to measure pain. A patient is asked to indicate his/her perceived pain intensity (most commonly) along a 100 mm horizontal line, and this rating is then measured from the left edge |
| Change from baseline in pain on the 10 point VAS scale at postoperative 7th day | Baseline and postoperative day 7 | The visual analog scale (VAS) is a tool widely used to measure pain. A patient is asked to indicate his/her perceived pain intensity (most commonly) along a 100 mm horizontal line, and this rating is then measured from the left edge |
| Change from baseline in pain on the 10 point VAS scale at postoperative 3rd day | Baseline and postoperative day 3 | The visual analog scale (VAS) is a tool widely used to measure pain. A patient is asked to indicate his/her perceived pain intensity (most commonly) along a 100 mm horizontal line, and this rating is then measured from the left edge |
Countries
Turkey (Türkiye)