Geriatric Patients, Neurocognitive Function, Postoperative Cognitive Dysfunction (POCD), Sedation and Analgesia
Conditions
Keywords
Target-Controlled Infusion (TCI), Manual Infusion, Geriatric Patients, Mini-Mental State Examination (MMSE)
Brief summary
This prospective observational study aims to evaluate the effects of target-controlled infusion (TCI) on postoperative neurocognitive function in geriatric patients undergoing major non-cardiac surgery. Elderly patients are at increased risk of postoperative cognitive dysfunction due to physiological changes and anesthesia-related factors. In this study, sedation management with TCI will be compared to manual infusion. Neurocognitive function will be assessed at multiple time points using the Mini-Mental State Examination (MMSE), and sedation levels will be monitored with the Bispectral Index (BIS) and the Richmond Agitation-Sedation Scale (RASS). The study aims to provide insights into safer sedation practices and improved cognitive outcomes in elderly surgical patients.
Interventions
None listed
Sponsors
Namigar Turgut
Study design
Observational model
COHORT
Time perspective
PROSPECTIVE
Eligibility
Sex/Gender
ALL
Age
65 Years to No maximum
Healthy volunteers
No
Inclusion criteria
* Patients aged 65 years and older * Undergoing noncardiac, nonneurosurgical major surgery under general anesthesia * Monitored postoperatively in the intensive care unit * Provided informed consent to participate in the study
Exclusion criteria
* Cardiac or neurosurgical procedures * Patients younger than 65 years * Glasgow Coma Scale \< 8 * No informed consent * Body mass index (BMI) \> 35 * Communication difficulties preventing cognitive testing * Known allergy to study medications
Design outcomes
Primary
| Measure | Time frame | Description |
|---|---|---|
| Change in neurocognitive function score (Mini-Mental State Examination,MMSE) | Preoperative baseline (within 24 hours before anesthesia) to 72 hours postoperatively | Between-group difference in the change of Mini-Mental State Examination (MMSE) total score from baseline to 72 hours after surgery, comparing target-controlled infusion (TCI) versus manual infusion. The MMSE is a widely used cognitive screening tool with a total score range of 0 to 30, where higher scores indicate better cognitive function. |
Secondary
| Measure | Time frame | Description |
|---|---|---|
| Total sedative and analgesic drug consumption | From admission to the intensive care unit (ICU) until completion of the postoperative sedation period (approximately 0-72 hours postoperatively). | Total amount of sedative and analgesic medications administered during the postoperative sedation period in both groups (TCI vs manual infusion). Lower consumption may indicate more efficient sedation management. |
| Hospital length of stay | From the day of surgery until hospital discharge (up to 40 days). | Total duration of hospitalization from the day of surgery until the patient is medically ready for discharge. Comparisons will be made between the TCI and manual infusion groups to evaluate whether postoperative sedation method influences overall hospital stay. |
Countries
Turkey (Türkiye)
Outcome results
None listed