The Effect of the Perioperative Blood Pressure on the Onset of Postoperative Cognitive Dysfunction in Adults
Overview
- Phase
- Not Applicable
- Intervention
- Not specified
- Conditions
- Mild Cognitive Impairment
- Sponsor
- University Hospital Hradec Kralove
- Enrollment
- 100
- Locations
- 1
- Primary Endpoint
- Change in cognitive behavior
- Status
- Completed
- Last Updated
- 7 years ago
Overview
Brief Summary
Permanent and temporary cognitive impairment in the perioperative period is of great importance to patients. Hypoperfusion due to the intraoperative hypotension is often mentioned as a possible cause of postoperative cognitive dysfunction.
Detailed Description
All patients aged above 60 years undergoing planned spinal surgery in the prone position in the duration of 1-3 hours under general anesthesia will be included in the study. In group L (liberal), the value of blood pressure will be corrected with the change of mean arterial pressure (MAP) ± 25% patient's mean arterial pressure, and group R (restrictive) with the change of MAP ± 10%. Cognitive dysfunction tests will be executed on the day before the surgery, two hours after the surgery and on the third postoperative day. Anesthesia will be managed according to the standardised protocol. Concentration of desflurane will be adjusted according to entropy values (target 40-50). Analgetics will be applied according to surgical pleth index (SPI) values. Sufentanil will not be applied in the last 15 minutes. Extubation will be performed at the operating theatre when meeting all extubation criteria including train of four ratio (TOFR) above 92%. Neither syntophyllin, nor pharmacological decurarization (syntostigmin) will be applied to the patients.
Investigators
Dostalova Vlasta, MD, PhD
Dostalova Vlasta, MD, PhD
University Hospital Hradec Kralove
Eligibility Criteria
Inclusion Criteria
- •ASA risk I - III
- •planned spinal surgery in the prone position
- •duration of the procedure of 1-3 hours
Exclusion Criteria
- •hypertension above 180/100 torr preoperatively
- •blood pressure below 130/80 torr preoperatively
Outcomes
Primary Outcomes
Change in cognitive behavior
Time Frame: within the first 3 days after surgery
measured by Addenbrooks cognitive test