ElderlySurgeryDepth of AnesthesiaTotal Intravenous AnesthesiaDelayed Neurocognitive Recovery
Investigational drug(s) / intervention(s)
Light anesthesiaDeep anesthesia
Light anesthesia: Anesthesia will be maintained by target-controlled infusion of propofol and remifentanil at a fixed ratio; the target BIS is 50.
Deep anesthesia: Anesthesia will be maintained by target-controlled infusion of propofol and remifentanil at a fixed ratio; the target BIS is 35.
Study summary
The impact of anesthesia depths on early postoperative neurocognitive complications after total intravenous anesthesia (TIVA) remains controversial. In some studies investigating TIVA, anesthesiologists mainly achieve the target depth of anesthesia by adjusting the dose of propofol, whereas the doses of opioids remains comparable between different anesthetic depth groups, possibly resulting inadequate analgesia. This study is aimed to investigate the impact of different anesthesia depths maintained by target-controlled infusion of propofol and remifentanil at a fixed ratio on the incidence of early postoperative neurocognitive complications in older patients undergoing noncardiac surgery.
Eligibility
Sex
ALL
Min age
65 Years
Max age
—
Healthy volunteers
No
Inclusion Criteria:
1. Aged ≥ 65 years.
2. Scheduled to undergo noncardiac surgery expected to last ≥ 1 hour under general anesthesia.
3. Require patient-controlled intravenous analgesia after surgery.
4. Provide written informed consent.
Exclusion Criteria:
1. Inability to communicate in the preoperative period because of coma, profound dementia, language barrier, or other reasons.
2. Previous history of schizophrenia, epilepsy, Parkinson's disease, or myasthenia gravis.
3. Traumatic brain injury or neurosurgery.
4. Severe hepatic dysfunction (Child-Pugh class C), severe renal dysfunction (eGFR \<30 ml/min/1.73 m2), or critical illness (preoperative American Society of Anesthesiologists physical status classification ≥IV).
5. Planned ICU admission with endotracheal intubation after surgery.
6. Enrolled in the other studies.
7. Other reasons that are considered unsuitable for study participation by the responsible surgeons or investigators.
Primary outcome measure(s)
Incidence of delayed neurocognitive recovery — On day 4 or before hospital discharge after surgery. Cognitive function is assessed with the Montreal Cognitive Assessment (MoCA; scores range from 0 to 30, with higher scores indicating better cognitove function). A decrease of 1 SD or more from baseline is defined as cognitive decline.
Trial sites (1)
Facility
City
Region
Status
Peking University First Hospital
Beijing
Beijing Municipality
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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.
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