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Effect of Low Flow Anesthetics on Neurocognitive Decline in the Elderly

Completed
Conditions
Inhalation; Vapor
Neurocognitive Disorders
Interventions
Other: General anesthesia with high fresh gas flow
Other: General anesthesia with low fresh gas flow
Diagnostic Test: Mini mental state examination
Diagnostic Test: Visual Analogue Scale
Registration Number
NCT05548998
Lead Sponsor
Prof. Dr. Cemil Tascıoglu Education and Research Hospital Organization
Brief Summary

This study aims to investigate the effect of inhaled anesthetics with a low fresh gas flow on cognitive function of elderly patients undergoing elective surgery

Detailed Description

Geriatric patients scheduled to undergo surgery were tested with Mini Mental State Examination (MMSE) in the preoperative visit. MMSE was repeated postoperatively at the 6th hour, the 1st, 3rd, and 7th day. Visual analogue scale (VAS) test was performed simultaneously on the postoperative 6th hour, the 1st, 3rd, and 7th day. Two cohorts were created according to the amount of fresh gas flow (low flow vs high flow) in the maintenance phase of the inhalational anesthetic. MMSE scores were compared between cohorts and baseline. VAS scores were compared between cohorts.

Recruitment & Eligibility

Status
COMPLETED
Sex
All
Target Recruitment
230
Inclusion Criteria
  • Age>65
  • Consenting to participate
  • Scheduled for surgery longer than 2 hours under GA
  • Able to read and write
Exclusion Criteria
  • Age<65
  • Refusing to participate
  • Existing visual impairment preventing the patient from reading or writing
  • Unable to read and write
  • Existing major neurocognitive disorder
  • Use of TIVA or regional techniques
  • Allergies to the volatile agents
  • Uncontrolled DM, acute alcohol intoxication
  • Conditions increasing tissue oxygen consumption (sepsis, thyrotoxicosis, etc.)
  • Anticipation/existence of major hemorrhage
  • Haemodynamic instability > 10 min or more than 5 times intraoperatively

Study & Design

Study Type
OBSERVATIONAL
Study Design
Not specified
Arm && Interventions
GroupInterventionDescription
High flow cohort (HFA)General anesthesia with high fresh gas flowPatients, whose maintenance phase of anesthesia is managed with a fresh gas flow ≥ 1L/min, were included in this cohort.
High flow cohort (HFA)Visual Analogue ScalePatients, whose maintenance phase of anesthesia is managed with a fresh gas flow ≥ 1L/min, were included in this cohort.
Low flow cohort (LFA)Mini mental state examinationPatients, whose maintenance phase of anesthesia is managed with a fresh gas flow \< 1L/min, were included in this cohort.
High flow cohort (HFA)Mini mental state examinationPatients, whose maintenance phase of anesthesia is managed with a fresh gas flow ≥ 1L/min, were included in this cohort.
Low flow cohort (LFA)General anesthesia with low fresh gas flowPatients, whose maintenance phase of anesthesia is managed with a fresh gas flow \< 1L/min, were included in this cohort.
Low flow cohort (LFA)Visual Analogue ScalePatients, whose maintenance phase of anesthesia is managed with a fresh gas flow \< 1L/min, were included in this cohort.
Primary Outcome Measures
NameTimeMethod
Change from baseline in neurocognitive status on the 30 point MMSE at postoperative 24th hourBaseline and postoperative day 1

A Mini-Mental State Examination (MMSE) is a set of 11 questions that doctors and other healthcare professionals commonly use to check for cognitive impairment (problems with thinking, communication, understanding and memory).

Secondary Outcome Measures
NameTimeMethod
Change from baseline in neurocognitive status on the 30 point MMSE at postoperative 3rd dayBaseline and postoperative day 3

A Mini-Mental State Examination (MMSE) is a set of 11 questions that doctors and other healthcare professionals commonly use to check for cognitive impairment (problems with thinking, communication, understanding and memory).

Change from baseline in pain on the 10 point VAS scale at postoperative 6th hourBaseline and postoperative hour 6

The visual analog scale (VAS) is a tool widely used to measure pain. A patient is asked to indicate his/her perceived pain intensity (most commonly) along a 100 mm horizontal line, and this rating is then measured from the left edge

Change from baseline in pain on the 10 point VAS scale at postoperative 3rd dayBaseline and postoperative day 3

The visual analog scale (VAS) is a tool widely used to measure pain. A patient is asked to indicate his/her perceived pain intensity (most commonly) along a 100 mm horizontal line, and this rating is then measured from the left edge

Change from baseline in neurocognitive status on the 30 point MMSE at postoperative 6th hourBaseline and postoperative hour 6

A Mini-Mental State Examination (MMSE) is a set of 11 questions that doctors and other healthcare professionals commonly use to check for cognitive impairment (problems with thinking, communication, understanding and memory).

Change from baseline in neurocognitive status on the 30 point MMSE at postoperative 7th dayBaseline and postoperative day 7

A Mini-Mental State Examination (MMSE) is a set of 11 questions that doctors and other healthcare professionals commonly use to check for cognitive impairment (problems with thinking, communication, understanding and memory).

Change from baseline in pain on the 10 point VAS scale at postoperative 24th hourBaseline and postoperative hour 24

The visual analog scale (VAS) is a tool widely used to measure pain. A patient is asked to indicate his/her perceived pain intensity (most commonly) along a 100 mm horizontal line, and this rating is then measured from the left edge

Change from baseline in pain on the 10 point VAS scale at postoperative 7th dayBaseline and postoperative day 7

The visual analog scale (VAS) is a tool widely used to measure pain. A patient is asked to indicate his/her perceived pain intensity (most commonly) along a 100 mm horizontal line, and this rating is then measured from the left edge

Trial Locations

Locations (1)

Prof. Dr. Cemil Taşcıoğlu City Hospital

🇹🇷

Istanbul, Turkey

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