The Post Anaesthesia N-Acetycysteine Cognitive Evaluation trial, investigating the potential for N-Acetylcysteine to reduce cognitive dysfunction following major elective non-cardiac surgery

Aims: * To examine the effectiveness of NAC in reducing POCD (primary aim) * To investigate the effectiveness of NAC in reducing biomarkers of neuroinflammation and oxidative stress in the perioperative setting * To examine the correlation between cognition and biomarkers * To identify possible predictors of POCD Hypotheses: * The administration of NAC in a perioperative setting is more effective than placebo in reducing the severity of early POCD, as measured by performance changes on a neuropsychological battery (primary hypothesis) * The administration of NAC in a perioperative setting is more effective than placebo in reducing the severity of long term POCD * The administration of NAC in a perioperative setting is more effective than placebo in reducing the incidence of post operative delirium * The administration of NAC in a perioperative setting is more effective than placebo in reducing the incidence of post operative mood disorders * The administration of NAC in a perioperative setting is more effective than placebo in improving quality of life * The administration of NAC in a perioperative setting is more effective than placebo in improving post surgical pain * The administration of NAC in a perioperative setting is more effective than placebo in reducing serum levels of biomarkers of neuroinflammation and oxidative stress