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Clinical Trial Details — Status: Recruiting

Administrative data

NCT number NCT04488952
Other study ID # 20193357001-XZ01
Secondary ID
Status Recruiting
Phase N/A
First received
Last updated
Start date July 8, 2020
Est. completion date June 1, 2024

Study information

Verified date April 2022
Source Shenzhen Second People's Hospital
Contact Zhiheng Liu, MD
Phone +86-0755-83366388
Email 15818585570@163.com
Is FDA regulated No
Health authority
Study type Interventional

Clinical Trial Summary

Perioperative Neurocognitive Disorders(PND) is a common perioperative complication among the elderly, especially in the plastic surgery. Different anesthesia methods have different incidences of PND, but it's still unknow which is better between spinal anesthesia and nerve block combined with general anesthesia. We will apply a psychometric battery test which contain different cognitive domains to estimate the incidence of PND at a week a month and a year after surgery with different anesthesia methods. Study has showed that functional magnetic resonance imaging (fMRI) could detect a cognitive decline through spontaneous neuronal activity in the cortex and hippocampus. In our study, multi-mode imaging technology is used to conduct in-depth research on MRI and make correlation analysis with cognitive function.


Recruitment information / eligibility

Status Recruiting
Enrollment 350
Est. completion date June 1, 2024
Est. primary completion date December 31, 2023
Accepts healthy volunteers Accepts Healthy Volunteers
Gender All
Age group 60 Years to 85 Years
Eligibility Inclusion Criteria: - aged 60-85years - ASA I-III - Received elective surgery of unilateral lower extremity orthopedics - The anesthesia lasted more than 2 hours Exclusion Criteria: -

Study Design


Related Conditions & MeSH terms


Intervention

Device:
nerve block combined with general anesthesia
Patients in this group receive nerve block combined with general anesthesia.
spinal anesthesia
Patients in this group receive spinal anesthesia.

Locations

Country Name City State
China Shenzhen Second People's Hospital Shenzhen Guangdong

Sponsors (1)

Lead Sponsor Collaborator
Shenzhen Second People's Hospital

Country where clinical trial is conducted

China, 

References & Publications (24)

Alkire MT, Pomfrett CJ, Haier RJ, Gianzero MV, Chan CM, Jacobsen BP, Fallon JH. Functional brain imaging during anesthesia in humans: effects of halothane on global and regional cerebral glucose metabolism. Anesthesiology. 1999 Mar;90(3):701-9. — View Citation

Berggren D, Gustafson Y, Eriksson B, Bucht G, Hansson LI, Reiz S, Winblad B. Postoperative confusion after anesthesia in elderly patients with femoral neck fractures. Anesth Analg. 1987 Jun;66(6):497-504. — View Citation

Bittner EA, Yue Y, Xie Z. Brief review: anesthetic neurotoxicity in the elderly, cognitive dysfunction and Alzheimer's disease. Can J Anaesth. 2011 Feb;58(2):216-23. doi: 10.1007/s12630-010-9418-x. Epub 2010 Dec 21. Review. — View Citation

Chen MH, Liao Y, Rong PF, Hu R, Lin GX, Ouyang W. Hippocampal volume reduction in elderly patients at risk for postoperative cognitive dysfunction. J Anesth. 2013 Aug;27(4):487-92. doi: 10.1007/s00540-012-1548-6. Epub 2013 Jan 31. — View Citation

Evered L, Silbert B, Knopman DS, Scott DA, DeKosky ST, Rasmussen LS, Oh ES, Crosby G, Berger M, Eckenhoff RG; Nomenclature Consensus Working Group. Recommendations for the nomenclature of cognitive change associated with anaesthesia and surgery-2018. Br J Anaesth. 2018 Nov;121(5):1005-1012. doi: 10.1016/j.bja.2017.11.087. Epub 2018 Jun 15. Review. — View Citation

Hole A, Terjesen T, Breivik H. Epidural versus general anaesthesia for total hip arthroplasty in elderly patients. Acta Anaesthesiol Scand. 1980 Aug;24(4):279-87. — View Citation

Knopman DS, Roberts RO, Geda YE, Pankratz VS, Christianson TJ, Petersen RC, Rocca WA. Validation of the telephone interview for cognitive status-modified in subjects with normal cognition, mild cognitive impairment, or dementia. Neuroepidemiology. 2010;34(1):34-42. doi: 10.1159/000255464. Epub 2009 Nov 5. — View Citation

Li WX, Luo RY, Chen C, Li X, Ao JS, Liu Y, Yin YQ. Effects of propofol, dexmedetomidine, and midazolam on postoperative cognitive dysfunction in elderly patients: a randomized controlled preliminary trial. Chin Med J (Engl). 2019 Feb;132(4):437-445. doi: 10.1097/CM9.0000000000000098. — View Citation

Maekawa K, Baba T, Otomo S, Morishita S, Tamura N. Low pre-existing gray matter volume in the medial temporal lobe and white matter lesions are associated with postoperative cognitive dysfunction after cardiac surgery. PLoS One. 2014 Jan 27;9(1):e87375. doi: 10.1371/journal.pone.0087375. eCollection 2014. — View Citation

Mason SE, Noel-Storr A, Ritchie CW. The impact of general and regional anesthesia on the incidence of post-operative cognitive dysfunction and post-operative delirium: a systematic review with meta-analysis. J Alzheimers Dis. 2010;22 Suppl 3:67-79. doi: 10.3233/JAD-2010-101086. Review. — View Citation

Moller JT, Cluitmans P, Rasmussen LS, Houx P, Rasmussen H, Canet J, Rabbitt P, Jolles J, Larsen K, Hanning CD, Langeron O, Johnson T, Lauven PM, Kristensen PA, Biedler A, van Beem H, Fraidakis O, Silverstein JH, Beneken JE, Gravenstein JS. Long-term postoperative cognitive dysfunction in the elderly ISPOCD1 study. ISPOCD investigators. International Study of Post-Operative Cognitive Dysfunction. Lancet. 1998 Mar 21;351(9106):857-61. Erratum in: Lancet 1998 Jun 6;351(9117):1742. — View Citation

Norkiene I, Samalavicius R, Ivaškevicius J, Budrys V, Paulauskiene K. Asymptomatic carotid artery stenosis and cognitive outcomes after coronary artery bypass grafting. Scand Cardiovasc J. 2011 Jun;45(3):169-73. doi: 10.3109/14017431.2011.562525. Epub 2011 Mar 15. — View Citation

O'Hara DA, Duff A, Berlin JA, Poses RM, Lawrence VA, Huber EC, Noveck H, Strom BL, Carson JL. The effect of anesthetic technique on postoperative outcomes in hip fracture repair. Anesthesiology. 2000 Apr;92(4):947-57. — View Citation

Peng L, Xu L, Ouyang W. Role of peripheral inflammatory markers in postoperative cognitive dysfunction (POCD): a meta-analysis. PLoS One. 2013 Nov 13;8(11):e79624. doi: 10.1371/journal.pone.0079624. eCollection 2013. — View Citation

Price CC, Tanner JJ, Schmalfuss I, Garvan CW, Gearen P, Dickey D, Heilman K, McDonagh DL, Libon DJ, Leonard C, Bowers D, Monk TG. A pilot study evaluating presurgery neuroanatomical biomarkers for postoperative cognitive decline after total knee arthroplasty in older adults. Anesthesiology. 2014 Mar;120(3):601-13. doi: 10.1097/ALN.0000000000000080. — View Citation

Rasmussen LS, Johnson T, Kuipers HM, Kristensen D, Siersma VD, Vila P, Jolles J, Papaioannou A, Abildstrom H, Silverstein JH, Bonal JA, Raeder J, Nielsen IK, Korttila K, Munoz L, Dodds C, Hanning CD, Moller JT; ISPOCD2(International Study of Postoperative Cognitive Dysfunction) Investigators. Does anaesthesia cause postoperative cognitive dysfunction? A randomised study of regional versus general anaesthesia in 438 elderly patients. Acta Anaesthesiol Scand. 2003 Mar;47(3):260-6. — View Citation

Ruff RM, Light RH, Parker SB, Levin HS. The psychological construct of word fluency. Brain Lang. 1997 May;57(3):394-405. — View Citation

Shi J, Tian J, Wei M, Miao Y, Wang Y. The utility of the Hopkins Verbal Learning Test (Chinese version) for screening dementia and mild cognitive impairment in a Chinese population. BMC Neurol. 2012 Nov 7;12:136. doi: 10.1186/1471-2377-12-136. — View Citation

Silbert B, Evered L, Scott DA, McMahon S, Choong P, Ames D, Maruff P, Jamrozik K. Preexisting cognitive impairment is associated with postoperative cognitive dysfunction after hip joint replacement surgery. Anesthesiology. 2015 Jun;122(6):1224-34. doi: 10.1097/ALN.0000000000000671. — View Citation

Squire LR. Memory and the hippocampus: a synthesis from findings with rats, monkeys, and humans. Psychol Rev. 1992 Apr;99(2):195-231. Review. Erratum in: Psychol Rev 1992 Jul;99(3):582. — View Citation

Wei M, Shi J, Li T, Ni J, Zhang X, Li Y, Kang S, Ma F, Xie H, Qin B, Fan D, Zhang L, Wang Y, Tian J. Diagnostic Accuracy of the Chinese Version of the Trail-Making Test for Screening Cognitive Impairment. J Am Geriatr Soc. 2018 Jan;66(1):92-99. doi: 10.1111/jgs.15135. Epub 2017 Nov 14. — View Citation

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* Note: There are 24 references in allClick here to view all references

Outcome

Type Measure Description Time frame Safety issue
Primary Incidence of PND seven days after surgery seven days after surgery
Secondary Incidence of PND one month after surgery one month after surgery
Secondary Incidence of PND one year after surgery one year after surgery
Secondary Hospital stay one to two weeks after surgery
Secondary Number of patients entrance the ward of ICU after surgery one week post-operation
Secondary Mortality rate one year after surgery
Secondary Postoperative complications one month post-operation
Secondary ADL of frontal lobe,temporal lobe and occipital lobe one day pre-operation, one week post-operation
Secondary ADL of frontal lobe one day pre-operation, one week post-operation
Secondary BOLD of the whole brain one day pre-operation, one week post-operation
Secondary ADL of temporal lobe one day pre-operation, one week post-operation
Secondary ADL of occipital lobe one day pre-operation, one week post-operation
Secondary One year event-free survival one year after surgery
See also
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