Postoperative Cognitive Function After Different Anesthetic Techniques in Obese Patients
Effects of Low-Flow Sevoflurane, Normal-Flow Sevoflurane, and Total Intravenous Anesthesia on Postoperative Cognitive Function in Obese Patients Undergoing Laparoscopic Abdominal Surgery
研究概览
地位
详细说明
Obesity is associated with physiological alterations that may increase the risk of postoperative cognitive dysfunction (POCD). The influence of anesthetic techniques on postoperative cognitive outcomes in obese patients remains uncertain.
This prospective randomized study was conducted in obese patients (BMI ≥30 kg/m²) aged 18-65 years undergoing elective laparoscopic abdominal surgery under general anesthesia. Patients were randomly assigned to one of three groups: low-flow sevoflurane anesthesia, normal-flow sevoflurane anesthesia, or total intravenous anesthesia (TIVA). Anesthetic depth was monitored using bispectral index (BIS) monitoring and maintained between 40 and 60 in all groups.
The primary objective was to compare postoperative cognitive function among the three anesthetic techniques using the Mini-Mental State Examination (MMSE). MMSE scores were evaluated preoperatively, at postoperative 30 minutes, and on postoperative day 3.
Secondary objectives included comparison of recovery characteristics, including eye-opening time, extubation time, Modified Aldrete Recovery Scores, and perioperative hemodynamic parameters.
The study was approved by the Marmara University Faculty of Medicine Clinical Research Ethics Committee (Approval No. 09.2022.744) and written informed consent was obtained from all participants before enrollment.
研究类型
注册 (实际的)
阶段
- 不适用
联系人和位置
学习地点
-
-
Istanbul
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Istanbul、Istanbul、土耳其（türkiye）、34899
- Marmara University Faculty of Medicine Pendik Training and Research Hospital
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参与标准
资格标准
适合学习的年龄
- 成人
- 年长者
接受健康志愿者
描述
Inclusion Criteria:
- Age between 18 and 65 years
- Body mass index (BMI) ≥30 kg/m²
- ASA physical status I-III
- Scheduled for elective laparoscopic abdominal surgery
- Provision of written informed consent
Exclusion Criteria:
- History of psychiatric disease
- Dementia or known cognitive impairment
- Hearing or language disorders preventing MMSE assessment
- Refusal to participate
- Conversion from laparoscopic to open surgery
学习计划
研究是如何设计的？
设计细节
- 主要用途：治疗
- 分配：随机化
- 介入模型：并行分配
- 屏蔽：双倍的
武器和干预
参与者组/臂 |
干预/治疗 |
|---|---|
|
实验性的：Low-Flow Sevoflurane
Patients received sevoflurane anesthesia with a fresh gas flow of 1 L/min during maintenance of anesthesia.
Anesthetic depth was maintained with BIS values between 40 and 60.
|
Maintenance of general anesthesia with sevoflurane inhalation.
Patients were assigned to either low-flow (1 L/min) or normal-flow (3 L/min) fresh gas flow anesthesia protocols.
|
|
实验性的：Normal-Flow Sevoflurane
Patients received sevoflurane anesthesia with a fresh gas flow of 3 L/min during maintenance of anesthesia.
Anesthetic depth was maintained with BIS values between 40 and 60.
|
Maintenance of general anesthesia with sevoflurane inhalation.
Patients were assigned to either low-flow (1 L/min) or normal-flow (3 L/min) fresh gas flow anesthesia protocols.
|
|
实验性的：Total Intravenous Anesthesia (TIVA)
Patients received total intravenous anesthesia with propofol and remifentanil infusion.
Anesthetic depth was maintained with BIS values between 40 and 60.
|
Maintenance of total intravenous anesthesia using continuous propofol infusion under BIS monitoring.
Continuous remifentanil infusion was administered during maintenance of anesthesia according to study protocol.
|
研究衡量的是什么？
主要结果指标
结果测量 |
措施说明 |
大体时间 |
|---|---|---|
|
Mini-Mental State Examination (MMSE) Score
大体时间：Preoperative, postoperative 30 minutes, and postoperative day 3
|
Postoperative cognitive function assessed using the Mini-Mental State Examination (MMSE).
|
Preoperative, postoperative 30 minutes, and postoperative day 3
|
次要结果测量
结果测量 |
措施说明 |
大体时间 |
|---|---|---|
|
Eye Opening Time
大体时间：End of surgery
|
Time from discontinuation of anesthetic administration to spontaneous eye opening
|
End of surgery
|
|
Extubation Time
大体时间：End of surgery
|
Time from discontinuation of anesthetic administration to tracheal extubation.
|
End of surgery
|
|
Modified Aldrete Recovery Score
大体时间：Postoperative recovery period
|
Recovery status assessed using the Modified Aldrete Score.
|
Postoperative recovery period
|
|
heart rate
大体时间：During surgery
|
patient's intraoperative measured heart rate
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During surgery
|
|
mean arterial pressure
大体时间：during surgery
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patient's intraoperative measured mean arterial pressure
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during surgery
|
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oxygen saturation
大体时间：During surgery
|
oxygen saturation of the patient will be recorded
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During surgery
|
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end-tidal carbon dioxide
大体时间：During surgery
|
end-tidal carbon dioxide of the patient will be recorded
|
During surgery
|
合作者和调查者
调查人员
- 首席研究员：Ahmet Tunca, MD、Department of Anesthesiology and Reanimation, Gaziantep City Hospital
- 学习椅：Seniyye Ü Zengin, MD、Department of Anesthesiology and Reanimation, Marmara University Faculty of Medicine, Pendik Training and Research Hospital
- 研究主任：Meliha O Ergün, MD、Department of Anesthesiology and Reanimation, Marmara University Faculty of Medicine, Pendik Training and Research Hospital
研究记录日期
研究主要日期
学习开始 (实际的)
初级完成 (实际的)
研究完成 (实际的)
研究注册日期
首次提交
首先提交符合 QC 标准的
首次发布 (实际的)
研究记录更新
最后更新发布 (实际的)
上次提交的符合 QC 标准的更新
最后验证
更多信息
与本研究相关的术语
其他相关的 MeSH 术语
其他研究编号
- MU-09.2022.744
计划个人参与者数据 (IPD)
计划共享个人参与者数据 (IPD)？
IPD 计划说明
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