The Difference in Cerebral Oxygenation Between Propofol and Sevoflurane

Study Overview
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Brief Summary
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the purpose of this study is to investigate whether propofol and sevoflurane have difference effect on cerebral oxygenation .

Detailed Description
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the purpose of this study:(1) to investigate the incidence of preoperative cerebral oxygenation abnormity (SjvO2 <55%) and its relationship with intraoperative cerebral desaturation and POCD. (2) To investigate the change of intraoperative cerebral oxygen supply and demand balance and the incidence of cerebral desaturation in patients with abnormal preoperative cerebral oxygenation during sevoflurane anesthesia. (3)To investigate the incidence of early POCD in patients with abnormal preoperative cerebral oxygenation during sevoflurane and propofol anesthesia.

Official Title
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The Difference in Cerebral Oxygenation Between Propofol and Sevoflurane

Conditions
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Cerebral Hypoxia, Postoperative Cognitive Dysfunction

Intervention / Treatment
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* Procedure: propofol
* Procedure: sevoflurane


Participation Criteria
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Eligibility Criteria
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Inclusion Criteria: scheduled to take major surgery under general anesthesia over 18 years old classified as ASA class three or less Exclusion Criteria: have a diagnosis of cerebrovascular disorder

Ages Eligible for Study
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Minimum Age: 18 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 |
| --- | --- |
| Propofol-Abnormal<br>patients with preoperative SjvO2<55%,using the TIVA technology with propofol, | Procedure: propofol<br>* use total intravenous anesthesia with propofol<br>|
| Propofol-Normal<br>patients with preoperative SjvO2≥55%,using the TIVA technology with propofol, | Procedure: propofol<br>* use total intravenous anesthesia with propofol<br>|
| Sevoflurane-Abnormal<br>patients with preoperative SjvO2<55%,using the VIMA technology with sevoflurane, | Procedure: sevoflurane<br>* use inhalation anesthesia with sevoflurane<br>|
| Sevoflurane-Normal<br>patients with preoperative SjvO2≥55%,using the VIMA technology with sevoflurane, | Procedure: sevoflurane<br>* use inhalation anesthesia with sevoflurane<br>|

What is the study measuring?
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Primary Outcome Measures

| Outcome Measure | Measure Description | Time Frame |
| --- | --- | --- |
| the Incidence of Intraoperative Desaturation Between Propofol and Sevoflurane General Anesthesia | SjvO2 were measured before anesthesia, after intubation, every hour during operation, after extubation by jugular vein blood and atrial blood gas analysis.The incidence of intraoperative cerebral desaturation was recorded when SjvO2<50%. | baseline ,every hour in the operation period,after extubation | 

Secondary Outcome Measures

| Outcome Measure | Measure Description | Time Frame |
| --- | --- | --- |
| the Incidence of Postoperative Cognitive Disfunction(POCD)Between Propofol and Sevoflurane General Anesthesia | The incidence of early POCD was recorded. The MMSE score and the Montreal cognitive assessment (MoCA) score were recorded 1day before surgery, 1-3 day after surgery and 5-7 day after surgery. The POCD was defined as MMSE score illiterate group ≤ 17, primary and secondary school group ≤ 20, junior high school and above group ≤ 24，or the MoCA score decreased 20% with the baseline. | 1-3days、5-7days after operation | 
| the Change in the Level of Serum BDNF(Brain-derived Neurotrophic Factor ) Between Propofol and Sevoflurane Anesthesia |  | before anesthesia, after extubation ,1day after operation | 
| the Change in the Level of Serum s-100β Between Propofol and Sevoflurane Anesthesia |  | before anesthesia,after extubation,1 day after operation | 

 Terms related to the study
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Keywords Provided by Centre Hospitalier Valida
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propofol, jugular bulb oxygen saturation, postoperative cognitive dysfunction, sevoflurane