RecruitingNot ApplicableNCT06176144

Impact of Desflurane and Sevoflurane on Postoperative Delirium in Elderly Patients

Impact of Desflurane Versus Sevoflurane Anesthesia Maintenance Methods on Incidence of Postoperative Delirium in Elderly Patients

Sponsor

West China Hospital

Enrollment

890 participants

Start Date

Sep 10, 2023

Study Type

INTERVENTIONAL

Conditions

Delirium Postoperative Cognitive Dysfunction

Summary

Advanced age is a consistent risk factor for the incidence of postoperative cognitive decline, which is associated with longer hospital stays, decreased quality of life, and increased mortality. Anaesthetic drugs can also affect postoperative cognition, as their residual effects can alter central nervous system activity. Desflurane and sevoflurane are widely used volatile anesthetics. Choice anesthetics may influence the occurrence of postoperative delirium. However, evidence in this aspect is conflicting.

Eligibility

Min Age: 65 YearsMax Age: 90 Years

Inclusion Criteria3

Age ≥ 65 years and < 90 years;
Scheduled to undergo non-cardiac or non-neurosurgery with an expected duration of 2 hours or more, under general anesthesia;
Agree to participate, and give signed written informed consent.

Exclusion Criteria5

Preoperative history of schizophrenia, epilepsy, parkinsonism or any diseases of central nervous system;
Inability to communicate in the preoperative period (coma, dementia, language barrier, impaired hearing or vision);
Severe diseases in cardiovascular, respiratory, liver, kidney, or preoperative American Society of Anesthesiologists physical status classification ≥ IV;
Alcoholism and drug dependence;
Other reasons that are considered unsuitable for participation by the responsible surgeons or investigators (reasons must be recorded in the case report form).

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Interventions

DRUGDesflurane

Desflurane will be administered by inhalation for anesthesia maintenance. The concentration of inhaled desflurane will be adjusted to maintain the bispectral index (BIS) value between 40 and 60. Analgesia will be supplemented with remifentanil (administered by continuous infusion), and sufentanil (administered by intermittent injection).Towards the end of surgery, desflurane inhalational concentration will be decreased and sufentanil will be administered when necessary. Desflurane inhalation will be stopped at the end of surgery.

DRUGSevoflurane

Sevoflurane will be administered by inhalation for anesthesia maintenance. The concentration of inhaled sevoflurane will be adjusted to maintain the bispectral index (BIS) value between 40 and 60. Analgesia will be supplemented with remifentanil (administered by continuous infusion), sufentanil (administered by intermittent injection).Towards the end of surgery, sevoflurane inhalational concentration will be decreased and sufentanil will be administered when necessary. Sevoflurane inhalation will be stopped at the end of surgery.