Effect of Low Flow Anesthetics on Neurocognitive Decline in the Elderly

Prof. Dr. Cemil Tascıoglu Education and Research Hospital Organization

Status: Completed

Conditions: Inhalation; Vapor; Neurocognitive Disorders

Treatments: Other: General anesthesia with high fresh gas flow; Diagnostic Test: Visual Analogue Scale; Diagnostic Test: Mini mental state examination; Other: General anesthesia with low fresh gas flow

Study type: Observational

Funder types: Other

Identifiers

NCT05548998

1206

Details and patient eligibility

About

This study aims to investigate the effect of inhaled anesthetics with a low fresh gas flow on cognitive function of elderly patients undergoing elective surgery

Full description

Geriatric patients scheduled to undergo surgery were tested with Mini Mental State Examination (MMSE) in the preoperative visit. MMSE was repeated postoperatively at the 6th hour, the 1st, 3rd, and 7th day. Visual analogue scale (VAS) test was performed simultaneously on the postoperative 6th hour, the 1st, 3rd, and 7th day. Two cohorts were created according to the amount of fresh gas flow (low flow vs high flow) in the maintenance phase of the inhalational anesthetic. MMSE scores were compared between cohorts and baseline. VAS scores were compared between cohorts.

Enrollment: 230 patients

Sex: All

Ages: 65+ years old

Volunteers: No Healthy Volunteers

Inclusion criteria

• Age>65
• Consenting to participate
• Scheduled for surgery longer than 2 hours under GA
• Able to read and write

Exclusion criteria

• Age<65
• Refusing to participate
• Existing visual impairment preventing the patient from reading or writing
• Unable to read and write
• Existing major neurocognitive disorder
• Use of TIVA or regional techniques
• Allergies to the volatile agents
• Uncontrolled DM, acute alcohol intoxication
• Conditions increasing tissue oxygen consumption (sepsis, thyrotoxicosis, etc.)
• Anticipation/existence of major hemorrhage
• Haemodynamic instability > 10 min or more than 5 times intraoperatively

Trial design

230 participants in 2 patient groups

High flow cohort (HFA)

Description:

Patients, whose maintenance phase of anesthesia is managed with a fresh gas flow ≥ 1L/min, were included in this cohort.

Treatment:

Diagnostic Test: Mini mental state examination

Other: General anesthesia with high fresh gas flow

Diagnostic Test: Visual Analogue Scale

Low flow cohort (LFA)

Description:

Patients, whose maintenance phase of anesthesia is managed with a fresh gas flow \< 1L/min, were included in this cohort.

Treatment:

Diagnostic Test: Mini mental state examination

Other: General anesthesia with low fresh gas flow

Diagnostic Test: Visual Analogue Scale