Surgery Clinical Trial
Official title:
Cerebrovascular Autoregulation During Major Non-cardiac Surgery and Risk for Postoperative Cognitive Dysfunction in Elderly Patients
Cerebral blood flow is tightly regulated to ensure constant cerebral perfusion independently
from systemic blood pressure fluctuations. This mechanism is termed cerebrovascular
autoregulation and preserves adequate cerebral perfusion in a range between 50 and 150 mmHg
of cerebral perfusion pressure. Upper and lower autoregulatory limits may vary individually.
Beyond the autoregulatory range the protective autoregulatory response is lost, facilitating
cerebral ischemia or hyperemia.
The cerebrovascular response may be altered during general anesthesia, through direct effects
of anesthetic agents on the vascular tone, changes of arterial partial pressure of carbon
dioxide or the administration of vasoactive substances. The association of perioperative
impairment of cerebral autoregulation and postoperative cognitive function has been discussed
controversially.
- continuous monitoring of cerebrovascular autoregulation using the correlation method
- based on near-infrared spectroscopy and invasive blood pressure measurement an index
(COx) will be calculated
- autoregulation monitoring from anesthesia induction until emergence from anesthesia
- assessment of preoperative cognitive function during preanesthesia evaluation or on the
day before surgery
- assessment of postoperative cognitive function between day 3 and 14 following surgery
- evaluation of subjective cognitive complaints or attention deficits 3 months after
surgery
;
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