To explore the relationship between plasma orexin levels during the recovery period of elderly patients undergoing general anesthesia and the occurrence of emergence delirium, and to evaluate its sensitivity and specificity as an objective diagnostic indicator for emergence delirium
Study Type
OBSERVATIONAL
Enrollment
150
No Intervention: Observational Cohort
Ruijin Hospital Affiliated to Shanghai Jiao Tong University School of Medicine
Shanghai, Shanghai Municipality, China
Emergece Delirium
The CAM-ICU scale is administered at extubation and 20 minutes post-extubation during the PACU stay. A positive finding at either time point is defined as emergence delirium.
Time frame: During extubation and 20 minutes after extubation
Plasma Orexin
Peripheral venous blood samples (3 mL each) are collected at six time points: 30 minutes before anesthesia induction, after induction but before incision, 1 hour after incision, at volatile anesthetic discontinuation, at extubation, and 20 minutes post-extubation. Samples are placed in EDTA tubes, stored at 2-8°C, centrifuged at 3000 rpm for 15 minutes at 4°C, and the separated plasma is stored at -80°C. Plasma orexin-A levels are measured by ELISA by technicians blinded to group assignment.
Time frame: 30 minutes before anesthesia induction, after anesthesia induction but before surgical incision, 1 hour after surgical incision, at the time of discontinuation of volatile anesthetics, at extubation, and 20 minutes post-extubation
Postoperative Delirium
Postoperative delirium is assessed twice daily (8:00-10:00 and 18:00-20:00) from postoperative day 1 through day 5 using the CAM/CAM-ICU scale. A positive finding on any assessment is defined as the occurrence of postoperative delirium. The severity of delirium is evaluated using the DRS-R-98.
Time frame: 5 days post- operation
EEG power in alpha band
EEG power in alpha band is continuously recorded throughout the entire emergence period using the Pearlcare EEG monitor.
Time frame: From PACU admission to 20 minutes post-extubation
EEG power in beta band
EEG power in beta band is continuously recorded throughout the entire emergence period using the Pearlcare EEG monitor.
Time frame: From PACU admission to 20 minutes post-extubation
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EEG power in theta band
EEG power in theta band is continuously recorded throughout the entire emergence period using the Pearlcare EEG monitor.
Time frame: From PACU admission to 20 minutes post-extubation
EEG power in delta band
EEG power in delta band is continuously recorded throughout the entire emergence period using the Pearlcare EEG monitor.
Time frame: From PACU admission to 20 minutes post-extubation