Hypertension and Controlled Hypotension in the Elderly

Study Overview
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Brief Summary
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Comparision of Exposed Factors of Preoperative Hypertension and Intraoperative Controlled Hypotension on Postoperative Delirium in the Elderly under Radical Resection of Head, Neck and Maxillofacial Tumor

Detailed Description
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Postoperative delirium has a higher incidence in elderly patients after general anesthesia，and It is closely related to the type of surgery, the length of surgery, and the patient's physique.Because head and neck maxillofacial radical surgery requires free flap transplantation and longer duration,and hemorrhage is more when the primary focus is removed，Intraoperative blood pressure reduction is needed to reduce bleeding，therefore, hypoperfusion of craniocerebral blood flow will occur.Low cerebral perfusion is closely related to the occurrence of postoperative delirium.Patients undergoing this type of surgery have more preoperative complications，hypertension is particularly common.Therefore, this study mainly studied the correlation between the preoperative blood pressure level and the controlled hypotension level in patients with radical head and neck and maxillofacial tumors and the incidence of postoperative delirium.

Official Title
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Effect of Preoperative Hypertension and Controlled Hypotension on Postoperative Delirium in the Elderly

Conditions
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Delirium

Intervention / Treatment
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* Diagnostic Test: hypertension


Participation Criteria
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Eligibility Criteria
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Inclusion Criteria: Patients who underwent radical anesthesia for oral and maxillofacial malignant tumors in our hospital ASA grade is Ⅰ-Ⅱ Patient is older than 60 years Exclusion Criteria: The patient has mental and mental disorders (eg schizophrenia, Alzheimer's disease) There was severe anemia before operation (Hb<80g/L) Patients had cerebral vascular complications such as cerebral infarction and lacunar infarction before operation Patients who do not cooperate with this trial Long-term use of sedative drugs or analgesics

Ages Eligible for Study
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Minimum Age: 60 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 |
| --- | --- |
| hypertension<br>After admission, two or more of the three blood pressure measurements under the same period of calm state that met hypertension, and the patient reported that he had a history of hypertension and that the blood pressure reached the standard of hypertension in the previous non-medication state was included in the hypertension group | Diagnostic Test: hypertension<br>* If the patient has two or more blood pressure values ≥140/90mmHg in a calm state, he is included in this group<br>|
| non-hypertension<br>Patients who denied the history of hypertension and were not taking antihypertensive drugs after admission and had normal blood pressure measurements were included in the non-hypertensive group | |

What is the study measuring?
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Primary Outcome Measures

| Outcome Measure | Measure Description | Time Frame |
| --- | --- | --- |
| Degree of delirium | From the first to the third day after surgery, the patient will be evaluated for delirium using the CAM scale. | up to three days after surgery |