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The Effect of Circadian Clock System on Perioperative Cognitive Function of Elderly Patients

10 december 2019 uppdaterad av: Yanchao Yang, Shengjing Hospital
Postoperative cognitive dysfunction (POCD) is a common postoperative complication in patients aged 65 and above. It refers to the cognitive function changes such as memory decline and attention loss after anesthesia and surgery. In serious cases, people may also experience personality changes and decline in social behavior ability, which will develop into irreversible cognitive impairment.Some studies reported that 25.8% of elderly patients presented POCD one week after non-cardiac surgery, and the incidence at 3 months after surgery was still 9.9%, which could increase the mortality in the first year after surgery.In recent years, studies have also proved that POCD is associated with patients' inability to perform their original jobs after non-cardiac surgery.Postoperative cognitive dysfunction seriously affects the clinical outcome, in addition to medical costs and other issues will bring an impact on the society and family.With the aging of the population, how to prevent cognitive dysfunction in elderly patients is a major challenge for perioperative management.There is a certain correlation between circadian rhythm and the dosage of general anesthesia, and postoperative sleep disturbance may be related to the effect of anesthesia and surgery on circadian rhythm.Preoperative sleep deprivation is known to be an independent risk factor for postoperative cognitive dysfunction (POCD), but the circadian mechanisms involved after general anesthesia are not yet clear

Studieöversikt

Studietyp

Interventionell

Inskrivning (Förväntat)

120

Fas

  • Inte tillämpbar

Kontakter och platser

Det här avsnittet innehåller kontaktuppgifter för dem som genomför studien och information om var denna studie genomförs.

Studieorter

    • Liaoning
      • Shenyang, Liaoning, Kina, 110004
        • Rekrytering
        • Junchao hospital Zhu
        • Kontakt:

Deltagandekriterier

Forskare letar efter personer som passar en viss beskrivning, så kallade behörighetskriterier. Några exempel på dessa kriterier är en persons allmänna hälsotillstånd eller tidigare behandlingar.

Urvalskriterier

Åldrar som är berättigade till studier

65 år till 90 år (Äldre vuxen)

Tar emot friska volontärer

Nej

Kön som är behöriga för studier

Allt

Beskrivning

Inclusion Criteria:

  • preoperative sleep disorders
  • did not receive any preoperative chemoradiotherapy
  • the duration of surgery ≧3 hours

Exclusion Criteria:

  • History of schizophrenia
  • epilepsy
  • parkinson's disease or myasthenia gravis
  • Critical illness (preoperative American society of anesthesiologists (ASA) ASA >III)
  • severe liver insufficiency (ChildePugh grade C)
  • severe renal insufficiency (preoperative dialysis)
  • neurosurgery

Studieplan

Det här avsnittet ger detaljer om studieplanen, inklusive hur studien är utformad och vad studien mäter.

Hur är studien utformad?

Designdetaljer

  • Primärt syfte: Övrig
  • Tilldelning: Randomiserad
  • Interventionsmodell: Parallellt uppdrag
  • Maskning: Fyrdubbla

Vapen och interventioner

Deltagargrupp / Arm
Intervention / Behandling
Övrig: Day group
60 patients scheduled for elective laparoscopic abdominal surgeries under general anesthesia were randomly assigned to receive operation in the Day Group ( 8:00-12:00)
120 patients scheduled for elective laparoscopic abdominal surgeries under general anesthesia were randomly assigned to receive operation in the Day Group (8:00-12:00) and in the Night Group (18:00-22:00)
Övrig: Night group
60 patients scheduled for elective laparoscopic abdominal surgeries under general anesthesia were randomly assigned to receive operation in the Night Group (18:00-22:00)
120 patients scheduled for elective laparoscopic abdominal surgeries under general anesthesia were randomly assigned to receive operation in the Day Group (8:00-12:00) and in the Night Group (18:00-22:00)

Vad mäter studien?

Primära resultatmått

Resultatmått
Åtgärdsbeskrivning
Tidsram
postoperative sleep quality of one night before surgery
Tidsram: one night before the surgery
use sleep monitor to test the sleep quality one night before surgery
one night before the surgery
postoperative sleep quality of first night after surgery
Tidsram: the first night after surgery
use sleep monitor to test the sleep quality first night after surgery
the first night after surgery
postoperative sleep quality of third night after surgery
Tidsram: the third night after surgery
use sleep monitor to test the sleep quality third night after surgery
the third night after surgery

Sekundära resultatmått

Resultatmått
Åtgärdsbeskrivning
Tidsram
Preoperative cognitive function test
Tidsram: one day before surgery
use MMSE(Mini-mental state examination) scale to test the cognitive function one day before surgery. MMSE(Mini-mental state examination) is a simple test assessing several categories, such as orientation to time and place, short term memory, recall, attention, calculation, language and visuo-spatial abilities. Scores ranging from 30 to 24 usually indicate normal cognitive function, while lower scores suggest the presence of cognitive impairment: mild from 23 to 19, moderate from 18 to 10 and severe from 9 to 0
one day before surgery
Postoperative cognitive function test of 6 weeks after surgery
Tidsram: 6 weeks after surgery
use MMSE(Mini-mental state examination) scale to test the cognitive function 6 weeks after surgery. MMSE is a simple test assessing several categories, such as orientation to time and place, short term memory, recall, attention, calculation, language and visuo-spatial abilities. Scores ranging from 30 to 24 usually indicate normal cognitive function, while lower scores suggest the presence of cognitive impairment: mild from 23 to 19, moderate from 18 to 10 and severe from 9 to 0
6 weeks after surgery
Postoperative cognitive function test of 1 year after surgery
Tidsram: 1 year after surgery
use MMSE(Mini-mental state examination) scale to test the cognitive function 1 year after surgery. MMSE(Mini-mental state examination) is a simple test assessing several categories, such as orientation to time and place, short term memory, recall, attention, calculation, language and visuo-spatial abilities. Scores ranging from 30 to 24 usually indicate normal cognitive function, while lower scores suggest the presence of cognitive impairment: mild from 23 to 19, moderate from 18 to 10 and severe from 9 to 0
1 year after surgery
Postoperative cognitive function test of 3 years after surgery
Tidsram: 3 years after surgery
use MMSE(Mini-mental state examination) scale to test the cognitive function 3 years after surgery. MMSE(Mini-mental state examination) is a simple test assessing several categories, such as orientation to time and place, short term memory, recall, attention, calculation, language and visuo-spatial abilities. Scores ranging from 30 to 24 usually indicate normal cognitive function, while lower scores suggest the presence of cognitive impairment: mild from 23 to 19, moderate from 18 to 10 and severe from 9 to 0
3 years after surgery

Samarbetspartners och utredare

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Studieavstämningsdatum

Dessa datum spårar framstegen för inlämningar av studieposter och sammanfattande resultat till ClinicalTrials.gov. Studieposter och rapporterade resultat granskas av National Library of Medicine (NLM) för att säkerställa att de uppfyller specifika kvalitetskontrollstandarder innan de publiceras på den offentliga webbplatsen.

Studera stora datum

Studiestart (Förväntat)

1 januari 2020

Primärt slutförande (Förväntat)

30 november 2022

Avslutad studie (Förväntat)

31 december 2022

Studieregistreringsdatum

Först inskickad

10 december 2019

Först inskickad som uppfyllde QC-kriterierna

10 december 2019

Första postat (Faktisk)

11 december 2019

Uppdateringar av studier

Senaste uppdatering publicerad (Faktisk)

11 december 2019

Senaste inskickade uppdateringen som uppfyllde QC-kriterierna

10 december 2019

Senast verifierad

1 december 2019

Mer information

Termer relaterade till denna studie

Andra studie-ID-nummer

  • circadian clock

Läkemedels- och apparatinformation, studiedokument

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Studerar en amerikansk FDA-reglerad produktprodukt

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