Target-Controlled Infusion and Postoperative Neurocognitive Outcomes in Geriatric Patients

Namigar Turgut50 enrolled

Overview

This prospective observational study aims to evaluate the effects of target-controlled infusion (TCI) on postoperative neurocognitive function in geriatric patients undergoing major non-cardiac surgery. Elderly patients are at increased risk of postoperative cognitive dysfunction due to physiological changes and anesthesia-related factors. In this study, sedation management with TCI will be compared to manual infusion. Neurocognitive function will be assessed at multiple time points using the Mini-Mental State Examination (MMSE), and sedation levels will be monitored with the Bispectral Index (BIS) and the Richmond Agitation-Sedation Scale (RASS). The study aims to provide insights into safer sedation practices and improved cognitive outcomes in elderly surgical patients.

Study Type

OBSERVATIONAL

Enrollment

Conditions

Postoperative Cognitive Dysfunction (POCD)Neurocognitive Function Sedation and Analgesia Geriatric Patients

Eligibility

Sex: ALLMin age: 65 Years

Medical Language ↔ Plain English

Inclusion Criteria: * Patients aged 65 years and older * Undergoing noncardiac, nonneurosurgical major surgery under general anesthesia * Monitored postoperatively in the intensive care unit * Provided informed consent to participate in the study Exclusion Criteria: * Cardiac or neurosurgical procedures * Patients younger than 65 years * Glasgow Coma Scale \< 8 * No informed consent * Body mass index (BMI) \> 35 * Communication difficulties preventing cognitive testing * Known allergy to study medications

Outcomes

Primary Outcomes

Change in neurocognitive function score (Mini-Mental State Examination,MMSE)

Between-group difference in the change of Mini-Mental State Examination (MMSE) total score from baseline to 72 hours after surgery, comparing target-controlled infusion (TCI) versus manual infusion. The MMSE is a widely used cognitive screening tool with a total score range of 0 to 30, where higher scores indicate better cognitive function.

Time frame: Preoperative baseline (within 24 hours before anesthesia) to 72 hours postoperatively

Secondary Outcomes

Total sedative and analgesic drug consumption

Total amount of sedative and analgesic medications administered during the postoperative sedation period in both groups (TCI vs manual infusion). Lower consumption may indicate more efficient sedation management.

Time frame: From admission to the intensive care unit (ICU) until completion of the postoperative sedation period (approximately 0-72 hours postoperatively).

Hospital length of stay

Total duration of hospitalization from the day of surgery until the patient is medically ready for discharge. Comparisons will be made between the TCI and manual infusion groups to evaluate whether postoperative sedation method influences overall hospital stay.

Time frame: From the day of surgery until hospital discharge (up to 40 days).