Evaluating the Influence of the Strategy Intraoperative Anesthetic (Desflurane Versus Propofol) on Cognitive and Psychomotor Functions in Output Post Interventional Room Monitoring - COGNIDES (Cognides)

Assistance Publique - Hôpitaux de Paris

Status and phase

Completed

Phase 2

Conditions

Orthopedic Surgery

Total Hip Prosthesis

Total Knee Replacement

Treatments

Drug: Intraoperative anesthetic strategy by Propofol

Drug: Intraoperative anesthetic strategy by Desflurane

Study type

Interventional

Funder types

Other

Identifiers

NCT02036736

P120702

2012-005270-61 (Other Identifier)

Details and patient eligibility

About

The recovery of cognitive and psychomotor functions is best performed under anesthesia after desflurane when propofol in that obtaining a Aldrete score> 8/10 output of the allowing SSPI.

The principal objective is to compare the cognitive and psychomotor status of patients recovered an Aldrete score> 8/10 according to the anesthetic agent (propofol or desflurane) using three tests (Stroop test, Digit Symbol Substitution task and a test of verbal memory (visual verbal learning test) made SSPI.

Full description

The day before surgery, patients sign the consent and will be randomized. Then 3 tests (Stroop test, Digit Symbol Substitution Task and visual verbal learning test) will be performed. No anxiolysis will be given to the patient. The anesthetic induction will be with IV propofol (2-3 mg / kg). The maintenance will anesthetic, desflurane by for a minimum alveolar concentration of between 2% and 6% or propofol for intravenous anesthesia user target controlled. In SSPI, the Aldrete score will be evaluated every 5min. Upon obtaining a Aldrete score> 8/10, the day before the tests will be carried out again

Enrollment

60 patients

Sex

All

Ages

18 to 80 years old

Volunteers

No Healthy Volunteers

Inclusion criteria

Age ≥ 18 years and ≤ 80 years
ASA I, II
General anesthesia provided
Scheduled orthopedic surgery
Duration of surgery between one and three hours
Patient has given its written consent
Patient receiving medical health insurance

Exclusion criteria

MMS (Mini Mental State) ≤ 24
Patient does not speak or read or do not understand the French
Previous surgery within seven days
Coronary insufficiency, renal, hepatic
Chronic pulmonary disease
Obesity (BMI> 35)
Addiction
Chronic alcoholism
Hematocrit <25%
Personal and family history of malignant hyperthermia
Taking benzodiazepines or psychotropic within 24 hours preoperative
Psychiatric pathology being
Psychological or neurological disorder causing difficulties in understanding the study
Chronic pain and / or taking analgesics 3.
Pregnancy or breastfeeding
Disorder of hemostasis: platelets <80,000 / mm3, PT <50% TCA> 1.5 times the control.
Hypersensitivity to propofol or desflurane or any of the excipients
Patients allergic to soy and peanuts
History of liver disease, jaundice, unexplained fever, eosinophilia after administration of a halogenated anesthetic
Hypersensitivity to egg lecithin.