Impact of Anesthesia Maintenance Methods on Incidence of Postoperative Delirium

Summary

Surgery is one of the major treatment methods for patients with malignant tumor. And, alone with ageing process, more and more elderly patients undergo surgery for malignant tumor. Evidence emerges that choice of anesthetics, i.e., either inhalational or intravenous anesthetics, may influence the outcome of elderly patients undergoing cancer surgery. Delirium is a commonly occurred early postoperative cognitive complication in the elderly, and its occurrence is associated with the worsening outcomes. Choice anesthetics may influence the occurrence of postoperative delirium. However, evidence in this aspect is conflicting.

Conditions

• Delirium
• Postoperative Complications
• Postoperative Cognitive Dysfunction

Interventions

DRUG

Sevoflurane

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/continuous infusion), or fentanyl (administered by intermittent injection). Towards the end of surgery, sevoflurane inhalational concentration will be decreased and fentanyl/sufentanil will be administered when necessary. Sevoflurane inhalation will be stopped at the end of surgery.

DRUG

Propofol

Propofol will be administered by intravenous infusion for anesthesia maintenance. The infusion rate of propofol will be adjusted to maintain the BIS value between 40 and 60. Analgesia will be supplemented with remifentanil (administered by continuous infusion), sufentanil (administered by intermittent injection/continuous infusion), or fentanyl (administered by intermittent injection). Towards the end of surgery, propofol infusion rate will be decreased and fentanyl/sufentanil will be administered when necessary. Propofol infusion will be stopped at the end of surgery.

Sponsors & Collaborators

• Hebei Medical University Fourth Hospital

  collaborator OTHER

• The People's Hospital of Ningxia

  collaborator OTHER

• Beijing Shijitan Hospital, Capital Medical University

  collaborator OTHER

• Guizhou Provincial People's Hospital

  collaborator OTHER

• Affiliated Hospital of Qinghai University

  collaborator OTHER

• The Third Xiangya Hospital of Central South University

  collaborator OTHER

• Cancer Hospital of Guangxi Medical University

  collaborator OTHER

• Shanxi Provincial People's Hospital

  collaborator OTHER_GOV

• Zhongda Hospital

  collaborator OTHER

• The First Affiliated Hospital of Zhengzhou University

  collaborator OTHER

• Tang-Du Hospital

  collaborator OTHER

• Tianjin Nankai Hospital

  collaborator OTHER

• Shenzhen Second People's Hospital

  collaborator OTHER

• Peking University First Hospital

  lead OTHER

Principal Investigators

• Dong-Xin Wang, MD, PhD · Peking University First Hospital

Study Design

Allocation

RANDOMIZED

Purpose

PREVENTION

Masking

TRIPLE

Model

PARALLEL

Eligibility

Min Age

65 Years

Max Age

90 Years

Sex

ALL

Healthy Volunteers

No

Timeline & Regulatory

Start

2015-04-01

Primary Completion

2017-09-29

Completion

2017-11-26

Countries

• China

Study Locations