POCD in Elderly Patients Following Desflurane or Sevoflurane General Anesthesia

Study Overview
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Brief Summary
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The use of desflurane in elderly subjects (>65 years old) undergoing general anesthesia with endotracheal intubation will result in decreased POCD compared to sevoflurane if the patient's MAP is within 20% of the patient's baseline and the cerebral suppression state index stays within the moderately anesthetized range during general anesthesia.

Official Title
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Incidence of Postoperative Cognitive Dysfunction in Elderly Patients Following Desflurane or Sevoflurane General Anesthesia: A Randomized, Controlled Trial

Conditions
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1. Postoperative Cognitive Dysfunction

Intervention / Treatment
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* Other: The intervention will be Mini-Mental Status Examination (MMSE)


Participation Criteria
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Eligibility Criteria
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Inclusion Criteria: Adult patients (>65 years old) Scheduled for elective surgery requiring general anesthesia at LLUMC HSH Airway management expected to include endotracheal intubation Expected surgical duration 120 to 240 minutes Exclusion Criteria: Pre-existing significant psychiatric disease or mental status changes Clinically significant cardiovascular, respiratory, hepatic, renal,neurological, psychiatric, or metabolic disease Patient's weighing >50% ideal body weight Men: Ideal Body Weight (in kilograms) = 50 + 2.3 kg per inch over 5 feet Women: Ideal Body Weight (in kilograms) = 45.5 + 2.3kg per inch over 5 feet Patients who have undergone a general anesthetic within the past 7 days Patient refusal

Ages Eligible for Study
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Minimum Age: 65 Years

Sexes Eligible for Study
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All

Accepts Healthy Volunteers
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No

Study Plan
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How is the study designed?
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Arms and Interventions

| Participant Group/Arm | Intervention/Treatment |
| --- | --- |
| desflurane and sevoflurane<br>Subjects will be randomized to either desflurane or sevoflurane. They will be given the Mini Mental State exam at 1, 6 and 24 hours after the end of anesthesia. | Other: The intervention will be Mini-Mental Status Examination (MMSE)<br>* A questionnaire given to the study patient before and after the anesthetic at 1, 6 and 24 hours.<br>|

What is the study measuring?
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Primary Outcome Measures

| Outcome Measure | Measure Description | Time Frame |
| --- | --- | --- |
| POCD in Elderly Patients Following Desflurane or Sevoflurane General Anesthesia | The primary outcome measure will be changes in cognitive function after anesthesia as measured by MMSE. | Both groups will complete the MMSE at 1, 6, and 24 hours after the end of anesthesia or to disharge up to 7 days. | 

Secondary Outcome Measures

| Outcome Measure | Measure Description | Time Frame |
| --- | --- | --- |
| Secondary outcome measures will include: 1) time to extubation, anesthetic complications (e.g. coughing during extubation), 2) time to readiness for discharge from PACU, 3) length of hospital stay, and 4) any postoperative complications. |  | 24 hours to 7 days | 

 Terms related to the study
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Keywords Provided by Centre Hospitalier Valida
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problems with thinking after surgery;