Postoperative cognitive dysfunction (POCD) is one of the common complications after surgery and anesthesia. The pathogenesis of POCD is hypothesized to involve the interaction between anesthesia and immune response. Recent evidences proved that the proinflammatory mediators produced as a result of tissue trauma from surgery and immune response following administration of anesthesia could lead to blood brain barrier damage thus causing POCD. So far there have been several studies addressing the s
Conditions
Interventions
Inhalation anesthesia group - (to Aj. pup, please fill in this field),intravenous anesthesia group - (to Aj. pup, please fill in this field)
Experimental Drug,Experimental Drug
Inhalation anesthesia group ,intravenous anesthesia group
Sponsors
Department of Research, Faculty of Medicine Siriraj Hospital Mahidol University
Eligibility
Sex/Gender
Male
Age
65 Years to No maximum
Inclusion criteria
Inclusion criteria: 1. Patients with American Society of Anesthesiologists (ASA) physical status 1-3 2. Patients 65 years and older who underwent elective major urological surgery (prostatectomy, cystectomy, nephrectomy, robotic-assisted surgery etc.) and operation time 2-5 hour. 3. Patients who can speak, read and communicate in Thai4. Patient voluntarily participates in the study
Exclusion criteria
Exclusion criteria: 1. Patients who participated in other clinical trials in the past 90 days or more 4 times in the past year. 2. A patient who has a history of allergy to anesthetics. 3. A patient who has a condition that affects the mental, such as chronic alcohol consumption. Have a history of chronic opioid use have a psychiatric disorder, depression, or a history of taking psychotropic drugs, etc. 4. The patient has severe visual and hearing impairments, a barrier to communication 5. Patients who refused to participate in the study
Design outcomes
Primary
| Measure | Time frame |
|---|---|
| The incidence of PND (POD, dNCR, and postoperative NCD) after general anesthesia with desflurane or propofol after surgery: 1-3 days (POD), 5-9 days (dNCR), and 3-6 months (postoperative NCD) 3D-CAM and MoCA | — |
Secondary
| Measure | Time frame |
|---|---|
| Patients characteristics between Propofol and Desflurane groups Preoperative, Intraoperative, Postoperative Patient reported outcome using medical record,The serum biomarkers after general anesthesia with desflurane or propofol and their correlation with PND at preoperative, immediate postoperative, and at 24, 48 and 72 hour after surgery Patient reported outcome using medical record,The intraoperative complications between anesthesia with desflurane or propofol Intraoperative Patient reported outcome using medical record,Quality of life at pre-discharge and 3-6 months after surgery EQ5D5L,Length of Hospital stay Postoperative Patient reported outcome using medical record,Discharge status Postoperative Patient reported outcome using medical record,Recovery and postoperative complications Postoperative Patient reported outcome using medical record,The incidence of Postoperative Delirium Assessment form once a day from day 1 to day 3 after the operation 3-minute diagnostic assessment for CAM-defined delirium (3D-CAM),Activities of Daily Living at pre-discharge and 3-6 months after surgery Barthel Activities of Daily Living : ADL ,Instrumental Activities of Daily Living at pre-discharge and 3-6 months after surgery Lawton Instrumental Activities of Daily Living Scales: L-IADL | — |
Countries
Thailand
Contacts
Public ContactPawit Somnuke
Department of Anesthesiology Faculty of Medicine Siriraj Hospital, Mahidol University
Outcome results
None listed