The Effect of Desflurane Versus Sevoflurane Versus Propofol on Postoperative Delirium
The Effect of Desflurane Versus Sevoflurane Versus Propofol on Postoperative Delirium in Elderly Patients Undergoing Moderate- to High-risk Major Noncardiac Surgery - a Prospective, Observer-blinded, Randomized, Clinical Trial
Medical University of Vienna
1,332 participants
Sep 3, 2023
INTERVENTIONAL
Conditions
Summary
Patients over the age of 65 years are at increased risk for developing delirium after noncardiac surgeries, resulting in increased morbidity and mortality. The prevention of postoperative delirium has been classified as a public health priority. However, so far data regarding possible intraoperative interventions to reduce the incidence of postoperative delirium is very scarce. Due to the more rapid wash-in and wash-out times of desflurane as compared to sevoflurane or propofol it seems reasonable that desflurane might be beneficial for the prevention of postoperative delirium. Therefore, we evaluate the effect of maintenance of anesthesia using desflurane, sevoflurane or propofol on postoperative delirium in elderly patients undergoing moderate- to high-risk major noncardiac surgery.
Eligibility
Inclusion Criteria3
- Provide written informed consent
- ≥65 years of age
- Scheduled for elective major noncardiac surgery with estimated time of surgery ≥ 2 hours
Exclusion Criteria9
- Patients undergoing emergency surgery
- BMI \> 45 kg/m\^2
- History of diagnosed dementia
- Language, vision, or hearing impairments that may compromise cognitive assessments
- History of malignant hyperthermia
- History of structural muscle disease
- History of organ transplantation (kidney, liver, lung, heart)
- Patients undergoing hyperthermic intraperitoneal chemotherapy
- ICU patients undergoing surgery
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Interventions
After induction of anesthesia, maintenance of anesthesia will be performed using goal-directed administration of desflurane with an intraoperative goal of bispectral index (BIS) 50±10.
After induction of anesthesia, maintenance of anesthesia will be performed using goal-directed administration of sevoflurane with an intraoperative goal of bispectral index (BIS) 50±10.
After induction of anesthesia, maintenance of anesthesia will be performed using goal-directed administration of propofol with an intraoperative goal of bispectral index (BIS) 50±10.
Locations(2)
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NCT05990790