Influence of Postoperative Cognitive Function in Patients With Sevoflurane Postconditioning on Carotid Intima Stripped

Study Overview
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Brief Summary
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Brief summary: In order to get a better clinical plan for brain protection during perioperative anesthesia for high-risk patients - carotid intima stripped. We observing the hemodynamic changes of sevoflurane post-treatment in carotid intima stripped, the comparison of postoperative cognitive function and postoperative radiographic changes.

Official Title
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The Influence of Postoperative Cognitive Function in Patients With Sevoflurane Postconditioning on Carotid Intima Stripped

Conditions
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Postoperative Cognitive Dysfunction, Sevoflurane, Carotid Artery Intima Stripped

Intervention / Treatment
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* Drug: Sevoflurane inhalant product


Participation Criteria
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Eligibility Criteria
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Inclusion Criteria: American Society of Anesthesiologists（ASA）：II-III Aged between 40 and 80 years Patients scheduled for surgery of Carotid stenosis under general anaesthesia Exclusion Criteria: Has a history of mental illness can't cooperate, Serious heart block or cardiac decompensation or severe sinus slow (HR < 50 times/min), The abnormal nerve monitoring in operation, MMES preoperative score < 20 points, Any rescue unexpected occurred during the operation

Ages Eligible for Study
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Minimum Age: 50 Years
Maximum Age: 80 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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Design Details

Primary Purpose: Other
Allocation: Randomized
Intervention Model: Single Group Assignment
Masking: Single


Arms and Interventions

| Participant Group/Arm | Intervention/Treatment |
| --- | --- |
| Experimental: Sevoflurane post conditioning group（S1）<br>propofol：0.05～0.1mg/(kg.min) maintain throughout the whole surgery ,1% sevoflurane plus after open Carotid artery until the end of surgery | Drug: Sevoflurane inhalant product<br>* propofol plus 1% sevoflurane after open Carotid artery until the end of surgery<br>|
| No Intervention: The control group（P）<br>propofol：0.05～0.1mg/(kg.min) maintain throughout the whole surgery without sevoflurane | |

What is the study measuring?
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Primary Outcome Measures

| Outcome Measure | Measure Description | Time Frame |
| --- | --- | --- |
| Change from the 1 day preoperative to the 1 day postoperative MMSE(Mini-mental State Examination) | Screening scale of cognitive function。The highest score is 30 points, 27 to 30 were divided into normal, less than 27 divided into cognitive dysfunction。But is not sensitive in the early identification of dementia, especially in mild cognitive impairment is poorer. | the 1st day before the surgery；the 1st day after the surgery | 
| Change from the 1 day preoperative to the 1 day postoperative MoCA(Montreal Cognitive Assessment) | Screening scale of cognitive function。The highest score is 30 points，Add 1 score, education the following subjects in less than 12 years。Total score less than 26 divided into cognitive dysfunction。Compared with MMSE, more sensitive to mild dementia。 | Time Frame: the 1st day before the surgery；the 1st day after the surgery | 

Secondary Outcome Measures

| Outcome Measure | Measure Description | Time Frame |
| --- | --- | --- |
| Heart rate | Heart rate per minute | Ten minutes before induction（T0) ,Intraoperative (Before the carotid artery occlusion（T1）), Intraoperative (before open the Carotid artery（T2)，At the end of the surgery when the surgeon completed sewing skin（T3），the 24 hours after the operation（T4） | 
| Invasive arterial blood pressure | Invasive arterial puncture catheter, continuous arterial pressure monitoring | Ten minutes before induction（T0) ,Intraoperative (Before the carotid artery occlusion（T1）), Intraoperative (before open the Carotid artery（T2)，At the end of the surgery when the surgeon completed sewing skin（T3），the 24 hours after the operation（T4） | 
| BIS | bispectral index | Ten minutes before induction（T0) ,Intraoperative (Before the carotid artery occlusion（T1）), Intraoperative (before open the Carotid artery（T2)，At the end of the surgery when the surgeon completed sewing skin（T3），the 24 hours after the operation（T4） | 
| PETCO2 | Partial pressure End-Tidal Carbon Dioxide | Ten minutes before induction（T0) ,Intraoperative (Before the carotid artery occlusion（T1）), Intraoperative (before open the Carotid artery（T2)，At the end of the surgery when the surgeon completed sewing skin（T3），the 24 hours after the operation（T4） | 
| Cerebral oxygen saturation | Cerebral oxygen saturation | Ten minutes before induction（T0) ,Intraoperative (Before the carotid artery occlusion（T1）), Intraoperative (before open the Carotid artery（T2)，At the end of the surgery when the surgeon completed sewing skin（T3），the 24 hours after the operation（T4） |