The Effects of Different Anesthesia Methods on Perioperative Neurocognitive Disorders in the Elderly

Study Overview
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Brief Summary
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Perioperative Neurocognitive Disorders(PND) is a common perioperative complication among the elderly, especially in the plastic surgery. Different anesthesia methods have different incidences of PND, but it's still unknow which is better between spinal anesthesia and nerve block combined with general anesthesia. We will apply a psychometric battery test which contain different cognitive domains to estimate the incidence of PND at a week a month and a year after surgery with different anesthesia methods. Study has showed that functional magnetic resonance imaging (fMRI) could detect a cognitive decline through spontaneous neuronal activity in the cortex and hippocampus. In our study, multi-mode imaging technology is used to conduct in-depth research on MRI and make correlation analysis with cognitive function.

Official Title
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The Effects of Different Anesthesia Methods on Perioperative Neurocognitive Disorders in the Elderly: a Randomized Controlled Trial

Conditions
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PND

Intervention / Treatment
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* Device: nerve block combined with general anesthesia
* Device: spinal anesthesia


Participation Criteria
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Eligibility Criteria
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Inclusion Criteria: aged 60-85years ASA I-III Received elective surgery of unilateral lower extremity orthopedics The anesthesia lasted more than 2 hours Exclusion Criteria: -

Ages Eligible for Study
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Minimum Age: 60 Years
Maximum Age: 85 Years

Sexes Eligible for Study
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All

Accepts Healthy Volunteers
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Accepts Healthy Volunteers

Study Plan
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How is the study designed?
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Design Details

Primary Purpose: Prevention
Allocation: Randomized
Intervention Model: Parallel Assignment
Masking: None (Open Label)


Arms and Interventions

| Participant Group/Arm | Intervention/Treatment |
| --- | --- |
| Experimental: nerve block combined with general anesthesia group<br>Patients in this group receive nerve block combined with general anesthesia. | Device: nerve block combined with general anesthesia<br>* Patients in this group receive nerve block combined with general anesthesia.<br>Device: spinal anesthesia<br>* Patients in this group receive spinal anesthesia.<br>|
| Experimental: spinal anesthesia group<br>Patients in this group receive spinal anesthesia. | Device: nerve block combined with general anesthesia<br>* Patients in this group receive nerve block combined with general anesthesia.<br>Device: spinal anesthesia<br>* Patients in this group receive spinal anesthesia.<br>|
| Placebo Comparator: control group<br>This group is used to obtain the learning effect. | Device: nerve block combined with general anesthesia<br>* Patients in this group receive nerve block combined with general anesthesia.<br>Device: spinal anesthesia<br>* Patients in this group receive spinal anesthesia.<br>|

What is the study measuring?
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Primary Outcome Measures

| Outcome Measure | Measure Description | Time Frame |
| --- | --- | --- |
| Incidence of PND seven days after surgery |  | seven days after surgery | 

Secondary Outcome Measures

| Outcome Measure | Measure Description | Time Frame |
| --- | --- | --- |
| Incidence of PND one month after surgery |  | one month after surgery | 
| Incidence of PND one year after surgery |  | one year after surgery | 
| Hospital stay |  | one to two weeks after surgery | 
| Number of patients entrance the ward of ICU after surgery |  | one week post-operation | 
| Mortality rate |  | one year after surgery | 
| Postoperative complications |  | one month post-operation | 
| ADL of frontal lobe，temporal lobe and occipital lobe |  | one day pre-operation, one week post-operation | 
| ADL of frontal lobe |  | one day pre-operation, one week post-operation | 
| BOLD of the whole brain |  | one day pre-operation, one week post-operation | 
| ADL of temporal lobe |  | one day pre-operation, one week post-operation | 
| ADL of occipital lobe |  | one day pre-operation, one week post-operation | 
| One year event-free survival |  | one year after surgery | 

 Terms related to the study
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Keywords Provided by Centre Hospitalier Valida
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PND,anesthesia method, elderly