1. To evaluate the effectiveness and safety of acupuncture on POD in diabetic patients undergoing surgery, to provide effective prevention and treatment measures of integrated traditional Chinese and western medicine for reducing the incidence of postoperative delirium in high-risk groups, and to provide clinical basis for further promotion of integrated traditional Chinese and western medicine anesthesia in the future. 2. To investigate the relationship between POD and rSO2 in diabetic patients undergoing surgery. To clarify the predictive value of intraoperative rSO2 monitoring on postoperative cognitive function in patients with diabetes, and to explore the effect of acupuncture on cerebral blood flow perfusion in patients with diabetes.
Postoperative delirium (POD) increases the risk of postoperative dementia and mortality. Cognitive decline is common in patients with diabetes mellitus. As an independent risk factor for POD, diabetes significantly increases postoperative dementia and mortality. Our team found that acupuncture can reduce the incidence of POD in elderly patients, increase regional cerebral oxygen saturation (rSO2), and increase cerebral blood flow perfusion in diabetic patients. In this study, a prospective randomized controlled study with placebo acupuncture will be conducted. Diabetic patients undergoing elective surgery will be divided into acupuncture group, placebo acupuncture group and control group. Acupuncture will be used as the intervention method, and the incidence of POD will be the main therapeutic effect evaluation index to explore the efficacy of acupuncture in the prevention and treatment of POD in diabetic patients undergoing surgery.
Study Type
INTERVENTIONAL
Allocation
RANDOMIZED
Purpose
PREVENTION
Masking
DOUBLE
Enrollment
215
treatment of pain or disease by inserting the tips of needles at specific points on the skin
placebo acupuncture
Incidence of postoperative delirium
assess the incidence of postoperative delirium using the 3-minute diagnostic confusion assessment method (3D-CAM)
Time frame: at 8 a.m. the day after surgery
Incidence of postoperative delirium
assess the incidence of postoperative delirium using 3D-CAM
Time frame: at 16 p.m. the day after surgery
Incidence of postoperative delirium
assess the incidence of postoperative delirium using 3D-CAM
Time frame: at 8 a.m. the second day after surgery
Incidence of postoperative delirium
assess the incidence of postoperative delirium using 3D-CAM
Time frame: at 16 p.m. the second day after surgery
Incidence of postoperative delirium
assess the incidence of postoperative delirium using 3D-CAM
Time frame: at 8 a.m. the third day after surgery
Incidence of postoperative delirium
assess the incidence of postoperative delirium using 3D-CAM
Time frame: at 16 p.m. the third day after surgery
Regional Saturation of Oxygenation (rSO2)
The brain oxygen saturation monitoring electrode was attached to the forehead, and the baseline level (T0) was recorded after the reading was stable under the condition of air inhalation. rSO2 readings were recorded after induction (T1), at the beginning of surgery (T2), one hour after the beginning of surgery (T3), at the end of surgery (T4), and after extubation (T5). The maximum and minimum values of rSO2 readings during surgery were recorded, and the area under the rSO2 curve was recorded when the rSO2 reading decreased by 13% from baseline for more than 5 minutes. rSO2 values of each time point, maximum and minimum values during surgery.
Time frame: baseline
Regional Saturation of Oxygenation (rSO2)
The brain oxygen saturation monitoring electrode was attached to the forehead, and the baseline level (T0) was recorded after the reading was stable under the condition of air inhalation. rSO2 readings were recorded after induction (T1), at the beginning of surgery (T2), one hour after the beginning of surgery (T3), at the end of surgery (T4), and after extubation (T5). The maximum and minimum values of rSO2 readings during surgery were recorded, and the area under the rSO2 curve was recorded when the rSO2 reading decreased by 13% from baseline for more than 5 minutes. rSO2 values of each time point, maximum and minimum values during surgery.
Time frame: the time when tracheal intubation finished
Regional Saturation of Oxygenation (rSO2)
The brain oxygen saturation monitoring electrode was attached to the forehead, and the baseline level (T0) was recorded after the reading was stable under the condition of air inhalation. rSO2 readings were recorded after induction (T1), at the beginning of surgery (T2), one hour after the beginning of surgery (T3), at the end of surgery (T4), and after extubation (T5). The maximum and minimum values of rSO2 readings during surgery were recorded, and the area under the rSO2 curve was recorded when the rSO2 reading decreased by 13% from baseline for more than 5 minutes. rSO2 values of each time point, maximum and minimum values during surgery.
Time frame: the time when the surgery begins
Regional Saturation of Oxygenation (rSO2)
The brain oxygen saturation monitoring electrode was attached to the forehead, and the baseline level (T0) was recorded after the reading was stable under the condition of air inhalation. rSO2 readings were recorded after induction (T1), at the beginning of surgery (T2), one hour after the beginning of surgery (T3), at the end of surgery (T4), and after extubation (T5). The maximum and minimum values of rSO2 readings during surgery were recorded, and the area under the rSO2 curve was recorded when the rSO2 reading decreased by 13% from baseline for more than 5 minutes. rSO2 values of each time point, maximum and minimum values during surgery.
Time frame: 1 hour after the beginning of the surgery
Regional Saturation of Oxygenation (rSO2)
The brain oxygen saturation monitoring electrode was attached to the forehead, and the baseline level (T0) was recorded after the reading was stable under the condition of air inhalation. rSO2 readings were recorded after induction (T1), at the beginning of surgery (T2), one hour after the beginning of surgery (T3), at the end of surgery (T4), and after extubation (T5). The maximum and minimum values of rSO2 readings during surgery were recorded, and the area under the rSO2 curve was recorded when the rSO2 reading decreased by 13% from baseline for more than 5 minutes. rSO2 values of each time point, maximum and minimum values during surgery.
Time frame: the time when the surgery ends
Regional Saturation of Oxygenation (rSO2)
The brain oxygen saturation monitoring electrode was attached to the forehead, and the baseline level (T0) was recorded after the reading was stable under the condition of air inhalation. rSO2 readings were recorded after induction (T1), at the beginning of surgery (T2), one hour after the beginning of surgery (T3), at the end of surgery (T4), and after extubation (T5). The maximum and minimum values of rSO2 readings during surgery were recorded, and the area under the rSO2 curve was recorded when the rSO2 reading decreased by 13% from baseline for more than 5 minutes. rSO2 values of each time point, maximum and minimum values during surgery.
Time frame: Intraoperative
Visual Analogue Score (VAS)
Record VAS. VAS is a psychometric response score. Draw a 10 cm horizontal line on the paper. The end of the line is 0, indicating no pain; the other end is 10, indicating severe pain. The middle part shows different levels of pain.
Time frame: at 8 a.m. and 16 p.m. daily for 3 days after surgery
Blood glucose levels
record blood glucose levels
Time frame: Entering the operating room, the time when the surgery ends
Expression of reactive oxygen species (ROS), superoxide dismutase (SOD), S100β in serum
The inflammation level will be assessed.
Time frame: Entering the operating room, the time when the surgery ends
Expression of peroxisome proliferators-activated receptor-γcoactivator-1α (PGC-1α)
assess the expression of PGC-1α
Time frame: Entering the operating room, the time when the surgery ends
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