The Effects of Anesthetics on Brain Network Connectivity in Patients With Supratentorial Glioma

Study Overview
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Brief Summary
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Perioperative anesthesia can affect postoperative cognitive function. In our previous study, intraoperative dexmedetomidine (Dex) infusion reduced the incidence of delirium within the first 5 days after brain tumor. However, the mechanism is still unclear. With the development of neuroimaging, multimodal neuroimaging technology provide a new method to explore the underlying mechanism. Therefore, the purpose of this study is to analyze the alterations of brain network under sedation and anesthesia by different anesthetics in patients with supratentorial glioma and their association with cognition.

Official Title
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The Alterations of Brain Network Connectivity Under Sedation and Anesthesia in Patients With Supratentorial Glioma

Conditions
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Brain Network Connectivity, Postoperative Delirium, Dexmedetomidine, Propofol

Intervention / Treatment
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* Drug: Dexmedetomidine
* Drug: Propofol


Participation Criteria
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Eligibility Criteria
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Inclusion Criteria: Diagnosed as unilateral supratentorial glioma by MRI Selective operation Age over 18 years old ASA I-II Right handedness Exclusion Criteria: History of cerebrovascular disease, brain trauma, chemotherapy and radiotherapy, or psychotropic drugs History of intracranial surgery Drug and/or alcohol abuse History of dementia or mental illness Pregnant or lactating women Contraindications for MRI Severe bradycardia (heart rate less than 40 beats per minute), sick sinus syndrome or second-to-third degree atrioventricular block Severe hepatic or renal dysfunction

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 |
| --- | --- |
| Dex group<br>Participants will be sedated and maintained by dexmedetomidine. | Drug: Dexmedetomidine<br>* Participants will be sedated and maintained by dexmedetomidine during the surgery.<br>|
| Propofol group<br>Participants will be sedated and maintained by propofol. | Drug: Propofol<br>* Participants will be sedated and maintained by propofol during the surgery.<br>|

What is the study measuring?
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Primary Outcome Measures

| Outcome Measure | Measure Description | Time Frame |
| --- | --- | --- |
| The alterations of brain network connectivity. | fMRI and DTI will be used to detect brain network connectivity. | Before sedation, 30 minutes after sedation，and 30 minutes after surgery. | 

Secondary Outcome Measures

| Outcome Measure | Measure Description | Time Frame |
| --- | --- | --- |
| Postoperative delirium. | The incidence and severity of postoperative delirium and its association with changes of brain network connectivity. | Day 1-5 after surgery. | 
| Electroencephalogram changes | Electroencephalogram will be used to record the brain activity. | From patients admission to operation room until 10 minutes after surgery | 
| rScO2 changes. | Regional cerebral oxygen saturation (rScO2) will be monitored with near-infrared spectroscopy (NIRS). | From patients admission to operation room until 10 minutes after surgery |