The Difference in Cerebral Oxygenation Between Propofol and Sevoflurane

First Affiliated Hospital, Sun Yat-Sen University144 enrolled

Overview

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

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.

Study Type

OBSERVATIONAL

Enrollment

144

Conditions

Cerebral Hypoxia Postoperative Cognitive Dysfunction

Interventions

propofolPROCEDURE

use total intravenous anesthesia with propofol

sevofluranePROCEDURE

use inhalation anesthesia with sevoflurane

Eligibility

Sex: ALLMin age: 18 Years

Medical Language ↔ Plain English

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

Locations (1)

the First Affiliated Hospital of Sun YetSen University

Guangzhou, Guangdong, China

Outcomes

Primary Outcomes

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%.

Time frame: baseline ,every hour in the operation period,after extubation

Secondary Outcomes

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.

Time frame: 1-3days、5-7days after operation

the Change in the Level of Serum BDNF(Brain-derived Neurotrophic Factor ) Between Propofol and Sevoflurane Anesthesia

Time frame: before anesthesia, after extubation ,1day after operation

the Change in the Level of Serum s-100β Between Propofol and Sevoflurane Anesthesia

Time frame: before anesthesia,after extubation,1 day after operation

Data from ClinicalTrials.gov

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