Anesthesia, Elderly, Postoperative Delirium
Conditions
Brief summary
Delirium is an acute confusional state, it is a sign of acute encephalopathy, also known as acute brain failure, acute brain dysfunction or mental state changes.Postoperative delirium can cause post-traumatic stress disorder, affects patients' quality of life, extend the length of hospital stay, increased hospitalization cost, and is closely relative to short-term and long-term mortality after surgery. Exogenous 40 Hz stimulation can improve cognitive functioning. Therefore, the aim of this study was to investigate the effect of exogenous 40Hz stimulation on the incidence of postoperative delirium in elderly patients undergoing hip and knee replacement.
Interventions
DEVICE40Hz stimulation
Exogenous 40HZ stimulation is a physical intervention that can drive oscillations in the gamma range, and the oscillations and pulses caused at the corresponding frequency can lead to a significant reduction in β-amyloid, reverse tau hyperphosphorylation, and thereby improve the cognitive function of patients.
Sponsors
Henan Provincial People's Hospital
Study design
Allocation
RANDOMIZED
Intervention model
PARALLEL
Primary purpose
PREVENTION
Masking
QUADRUPLE (Subject, Caregiver, Investigator, Outcomes Assessor)
Eligibility
Sex/Gender
ALL
Age
65 Years to 85 Years
Healthy volunteers
No
Inclusion criteria
1.65-85 years old, gender not limited 2.General anesthesia unilateral total hip replacement surgery or unilateral total knee replacement 3.ASA classification I-III 4.No drugs for mental and central nervous system diseases were used before surgery 5.Preoperative MMSE score illiterate \> 17 points, primary \> 20 points, junior high school and above \> 24 points 6.Obtaining informed consent
Exclusion criteria
1. Severe liver and kidney dysfunction 2. here were mental and nervous system diseases before operation 3. Have a history of alcoholism, long-term use of sedative or analgesic 4. A history of a delirium and other reasons are reluctant to cooperate 5. Massive blood loss and blood transfusion during operation, prolonged operation time
Design outcomes
Primary
| Measure | Time frame | Description |
|---|---|---|
| The incidence of postoperative delirium | Day 1, Day 2, Day 3 after surgery | Postoperative delirium was assessed by CAM scale.The diagnosis of delirium mainly depends on four characteristics: 1 acute fluctuating course; 2 attention disorder; 3 thinking disorder; 4 change of consciousness level. At the same time, 1 and 2, and 3 or 4 can be used to diagnose delirium. |
Secondary
| Measure | Time frame | Description |
|---|---|---|
| Blood Markers | Preoperative and postoperative 1 d and 2 d | Serum Tau proteomic analysis and CRP, IL-6, and B cell levels were recorded |
| The incidence of postoperative nausea and vomiting | Day 1, Day 2, Day 3 after surgery | Follow up patients for nausea and vomiting |
| Sleep quality | Day 1, day 2, day 3 after surgery | Sleep quality was assessed using a sleep quality scale(QS),(0: no effect on sleep 1: sleep in and out of sleep at night 2: sleep in and out of sleep unable to fall asleep 3: light sleep but unable to fall asleep 4: unable to fall asleep at all) |
| The incidence of pain | Day 1, day 2, day 3 after surgery | NRS is a dotted ruler from 0 to 10. 0 means no pain, and 10 means unbearable pain. The patient chooses a number from above to describe the pain. |
Countries
China
Contacts
Primary ContactZhang jiaqiang
Outcome results
None listed