Desflurane Potentially Induces Postoperative Cognitive Dysfunction in Elderly Patients Undergoing Perioperative Procedures by Modulating Cdc42 and Clock Proteins

NCT06772558 · tracked via the Priya Life Science China tracker

Sponsor

Xiaguang Duan

Phase

Not applicable

Started

2025-02-01

Last updated

2025-01-14

Condition(s) studied

Avascular Necrosis of the Femoral HeadCoronary Artery Disease (CAD)Benign Prostatic Hyperplasia (BPH)CholecystitisKnee Osteoarthritis

Investigational drug(s) / intervention(s)

Desflurane Inhalation →mechanical ventilation (MV)

Desflurane Inhalation: Anesthesia was maintained with either desflurane, with inhaled concentrations adjusted based on electroencephalogram (EEG) monitoring.

mechanical ventilation (MV): Following induction, patients underwent mechanical ventilation in volume-controlled (VC) mode. Ventilation parameters were set using a GE Aestiva anesthesia machine (GE Healthcare, Waukesha, Wisconsin, USA): tidal volume 6-8 ml/kg, positive end-expiratory pressure 0 cmH2O, inspiration/expiration ratio 1:2, respiratory rate 16 breaths/min, and inspired oxygen concentration of 41%.

Study summary

This clinical trial investigates whether desflurane induces postoperative cognitive dysfunction (POCD) in elderly patients undergoing perioperative procedures by modulating Cdc42 and Clock proteins. The primary research questions are: (1) Does desflurane administration contribute to POCD in this patient population? and (2) Are alterations in Cdc42 and Clock protein levels associated with desflurane-induced POCD in elderly patients? To address these questions, elderly patients will be administered desflurane for anesthesia maintenance. Postoperative assessments will then compare blood levels of Cdc42 and Clock proteins, and examine related signaling pathways, between a control group and a POCD group.

Study participants will receive desflurane anesthesia maintained at a Bispectral Index (BIS) value of 40-60. Postoperative cognitive function will be assessed on the second day using the Montreal Cognitive Assessment (MoCA), and participants will be categorized into either a control group or a POCD group based on MoCA performance. Cognitive function and blood levels of Cdc42 and Clock proteins will be recorded. Furthermore, the study will also investigate associated signaling pathways.

Eligibility

Sex

ALL

Min age

70 Years

Max age

—

Healthy volunteers

Inclusion Criteria: * Age \> 70 years * American Society of Anesthesiologists (ASA) physical status classification I-III * Scheduled to undergo elective surgery requiring general anesthesia with desflurane * Able and willing to provide voluntary written informed consent * Able to understand the study procedures and complete follow-up assessments Exclusion Criteria: * Pre-existing diagnosis of dementia or any other neurodegenerative disease that could affect cognitive function * Preoperative Montreal Cognitive Assessment (MoCA) score \< 20 * History of severe psychiatric disorders, including psychosis, severe depression, or bipolar disorder * Unstable angina, uncontrolled hypertension, or a history of myocardial infarction within the past 6 months * Severe chronic obstructive pulmonary disease (COPD) with significant respiratory compromise, or other significant respiratory disease * Severe hepatic or renal impairment, defined as Child-Pugh class C for liver disease, or glomerular filtration rate (GFR) \< 30 mL/min/1.73 m2 for kidney disease * History of stroke, transient ischemic attack (TIA), or other significant neurological disorders * History of alcohol or drug abuse * Patients with visual, auditory, or language impairments that would interfere with cognitive testing. * Known allergy or contraindication to any of the study drugs * Other conditions at the discretion of the investigator that could interfere with the conduct of the study or the interpretation of the results

Primary outcome measure(s)

Montreal Cognitive Assessment (MoCA) — At baseline (before therapy), at 2 days post-treatment
MoCA, is a rating system from 0 to 30, where 0 represents "no postoperative cognitive dysfunction" and 30 represents the worst possible postoperative cognitive dysfunction.

Trial sites (1)

Facility	City	Region	Status
Inner Mongolia Baogang Hospital	Baotou	Inner Mongolia

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Official registry record

This page summarises publicly available registry data for informational purposes — not medical advice. Eligibility is determined by each study team; patients should discuss participation with their clinician.

View NCT06772558 on ClinicalTrials.gov ↗ ← All trials in China