Obesity Clinical Trial
Official title:
Desflurane or Propofol Anesthesia in Elderly Obese Patients Undergoing Total Knee Replacement: A Pilot Assessment of Short-term and Long-term Differences in Outcome
Verified date | October 2015 |
Source | Stanford University |
Contact | n/a |
Is FDA regulated | No |
Health authority | United States: Institutional Review Board |
Study type | Interventional |
You are invited to participate in a research study assessing your mental status in the first days after your surgery and how you will be doing in the 2 years following the surgery. The investigators hope to learn more about the incidence of postoperative confusion and a possible relation with 2 anesthesia techniques that are routinely used. The first one is an anesthesia technique that uses the inhaled anesthetic gas desflurane and the second one is an anesthesia technique that uses the anesthetic propofol administered by infusion in a vein. The investigators are also looking to see if there is a relationship between anesthesia technique and cardiovascular outcomes. You were selected as a possible participant in this study because at your age this phenomenon appears to have a greater incidence.
Status | Completed |
Enrollment | 100 |
Est. completion date | July 2015 |
Est. primary completion date | July 2015 |
Accepts healthy volunteers | No |
Gender | Both |
Age group | 65 Years and older |
Eligibility |
Inclusion Criteria: - Age > 65 years old - Body mass index > 30 kg/m2 - Undergoing primary total knee arthroplasty surgery - American society of anesthesiology classification II-III Exclusion Criteria: - Patient refusal to participate in the study - Patient refusal or failure of regional block - Patients with preexisting neuro-cognitive disorders - Known intolerance to any of the drugs to be used according to the study protocol |
Allocation: Randomized, Intervention Model: Parallel Assignment, Masking: Single Blind (Outcomes Assessor), Primary Purpose: Treatment
Country | Name | City | State |
---|---|---|---|
United States | Stanford University School of Medicine | Stanford | California |
Lead Sponsor | Collaborator |
---|---|
Pedro Paulo Tanaka | Baxter Healthcare Corporation |
United States,
Type | Measure | Description | Time frame | Safety issue |
---|---|---|---|---|
Primary | Assessment of Delirium | The primary end point was the incidence of postoperative delirium as measured by the Confusion Assessment Method (CAM). | 48 hours | No |
Primary | Recall of Digit Span | • The Digit Span subtest of the Wechsler Adult Intelligence Scale-Revised is a test that requires subjects to repeat a series of digits that have been verbally presented to them both forward and, in a later independent test, reverse order. It measures attention and working memory | Change > 20% from baseline to 6-8 hours after surgery | No |
Primary | Recall of Digit Span | • The Digit Span subtest of the Wechsler Adult Intelligence Scale-Revised is a test that requires subjects to repeat a series of digits that have been verbally presented to them both forward and, in a later independent test, reverse order. It measures attention and working memory | Change > 20% from baseline to 48 hours after surgery | No |
Primary | Digit Symbol Substitution Test | • The Digit Symbol Substitution Test (DSST) measures attention, working memory, sustained visual attention and psychomotor speed. Subjects are given a table that pairs digits and symbols, and asked to decipher a code using the table, completing as many as possible in 90 seconds. The DSST has been found to be more sensitive than other tests to changes in high-levels of cognition | Change > 20% from baseline to 6-8 hours after surgery | No |
Primary | Digit Symbol Substitution Test | • The Digit Symbol Substitution Test (DSST) measures attention, working memory, sustained visual attention and psychomotor speed. Subjects are given a table that pairs digits and symbols, and asked to decipher a code using the table, completing as many as possible in 90 seconds. The DSST has been found to be more sensitive than other tests to changes in high-levels of cognition | Change > 20% from baseline to 48 hours after surgery | No |
Primary | Trail Making Part A | • Trail Making Test is an executive measure of sequencing and cognitive flexibility. Trail A requires the subject to rapidly sequence a straightforward series. The scoring for this test is the time in seconds required for completion of the test | Change > 20% from baseline to 6-8 hours after surgery | No |
Primary | Trail Making Part A | • Trail Making Test is an executive measure of sequencing and cognitive flexibility. Trail A requires the subject to rapidly sequence a straightforward series. The scoring for this test is the time in seconds required for completion of the test | Change > 20% from baseline to 48 hours after surgery | No |
Primary | Trail Making Part B | • Trail Making Test is an executive measure of sequencing and cognitive flexibility. Trail B is a more difficult cognitive flexibility task requiring the subject to follow a sequential pattern while shifting cognitive sets and reflects executive functioning, although other cognitive abilities, such as psychomotor speed and visual scanning, are necessary for successful completion of the task. The scoring for this test is the time in seconds required for completion of the test | Change > 20% from baseline to 6-8 hours after surgery | No |
Primary | Trail Making Part B | Trail Making Test is an executive measure of sequencing and cognitive flexibility. Trail B is a more difficult cognitive flexibility task requiring the subject to follow a sequential pattern while shifting cognitive sets and reflects executive functioning, although other cognitive abilities, such as psychomotor speed and visual scanning, are necessary for successful completion of the task. The scoring for this test is the time in seconds required for completion of the test | Change > 20% from baseline to 48 hours after surgery | No |
Secondary | - Time to Spontaneous Breathing After Desflurane/Propofol Discontinuation | first day | No | |
Secondary | - Time to Eye Opening After Desflurane/Propofol Discontinuation | first day | No | |
Secondary | - Time to Tracheal Extubation After Desflurane/Propofol Discontinuation | first day | No | |
Secondary | - Time to Following Command After Desflurane/Propofol Discontinuation | first day | No | |
Secondary | Nausea and Vomiting | 48 hours | No | |
Secondary | Recovery Room Time | first day | No | |
Secondary | B-type Natriuretic Peptide | Change from Baseline to day one | No | |
Secondary | N-terminal proBNP | Change from baseline to day one | No | |
Secondary | Troponin I | Patients who had troponin level > 0.2 ng/mL | 2 days | No |
Secondary | BNP | Change form baseline to post-operative day 2 | No | |
Secondary | ProBNP | Change from baseline to post-operative day 2 | No | |
Secondary | Duration of Surgery | Time from Incision to closure of surgery | No | |
Secondary | Duration of Anesthesia | Time from induction to extubation | No | |
Secondary | Amount of Intraoperative Fentanyl | From the anesthesia induction until extubation | No |
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