Cognitive Dysfunction Clinical Trial
Official title:
Postoperative Cognitive Dysfunction and Perioperative Myocardial Ischemia: Comparing Total IV Anesthesia and Inhalation Anesthesia.
The progressive aging of the general population cause increase in number of extensive and
long surgeries in older patients. Age is a risk factor for perioperative myocardial ischemia
and Postoperative Cognitive Dysfunction (POCD) The suggested study will deal with the
above-mentioned complication in patients older then 65 years undergoing major non-cardiac
surgeries.
It has been shown that Isoflurane and sevoflurane may have a cardio-protective effect after
cardiac surgery involving cardio-pulmonary bypass, and it was recommended that isoflurane
should be used in these cases. A question was raised but haven't been answered yet, whether
this cardio-protective effect exists also in non-cardiac major surgery.
The aim of this study is to evaluate whether there is a difference in the occurrence of
postoperative cognitive dysfunction and perioperative myocardial ischemia between total
intravenous anesthesia using propofol and isoflurane based anesthesia.
The progressive aging of the general population cause increase in number of extensive and
long surgeries in older patients. Age is a risk factor for perioperative myocardial ischemia
and Postoperative Cognitive Dysfunction (POCD) The suggested study will deal with the
above-mentioned complication in patients older then 65 years undergoing major non-cardiac
surgeries.
It has been shown that Isoflurane and sevoflurane may have a cardio-protective effect after
cardiac surgery involving cardio-pulmonary bypass, and it was recommended that isoflurane
should be used in these cases. A question was raised but haven't been answered yet, whether
this cardio-protective effect exists also in non-cardiac major surgery.
The aim of this study is to evaluate whether there is a difference in the occurrence of
postoperative cognitive dysfunction and perioperative myocardial ischemia between total
intravenous anesthesia using propofol and isoflurane based anesthesia.
The suggested study is a randomized controlled study. 500 patients older then 65 years
undergoing elective non-cardiac major surgeries will be studied.
On the day prior to surgery the patient will take a series computerized cognitive tests
(Mindstream® cognitive health assessment, neurotrax®, Modiin, Israel). At the holding area
before entering the operating room (OR) the patients will be randomly assigned to one of two
study groups.
Group 1 -IA: anesthesia will be maintained using Isoflurane carried by O2/air. Group 2 -
TIVA : anesthesia will be maintained with propofol. The patients will be followed for 3
months post-operatively. Cognitive function will be assessed 7 days and 3 months
postoperatively using computerized tests and telephone interview.
;
Observational Model: Cohort, Time Perspective: Prospective
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