Postoperative delirium is a common acute central nervous system syndrome, which often occurs 1-5 days after surgery. Postoperative delirium can prolong the length of hospital stay, increase the mortality rate, and is also associated with long-term postoperative cognitive dysfunction. However, the pathogenesis of postoperative delirium in elderly patients undergoing neurosurgical procedures, who are at high risk for ostoperative delirium, remains unclear. This study aims to elucidate the underlying mechanisms of postoperative delirium in this population and inform the development of effective prevention and treatment strategies.
Study Type
OBSERVATIONAL
Enrollment
164
Beijing Tian Tan Hospital, Capital Medical University
Beijing, Beijing Municipality, China
The association between intraoperative hypotension and postoperative delirium
Intraoperative hypotension was defined by absolute mean arterial pressure (MAP) thresholds (sustained MAP \< 75, 70, 65, or 60 mm Hg for \> 1 min) or relative MAP reductions (10%, 20%, 30%, or 40% below preoperative baseline). The Confusion Assessment Method for the Intensive Care Unit scale (CAM-ICU) or 3 min diagnostic interview for CAM (3D-CAM) will be applied to assess postoperative delirium.
Time frame: The surgery day and twice a day (from 8:00 to 10:00 and from 18:00 to 20:00) during the first postoperative 5 days.
Characteristic of electroencephalogram
Electroencephalographic signals will be acquired with the Masimo SedLine® monitor, which will yield the Patient State Index (PSI), burst-suppression ratio, raw EEG traces, density spectral array, spectral edge frequency, and electromyographic data. Frequency bands will be predefined as delta (1-3 Hz), theta (4-7 Hz), alpha (8-12 Hz), and beta (13-40 Hz). Relative power for each band will be computed relative to total spectral power.
Time frame: The surgery day
Regional cerebral oxygen saturation changes
Regional cerebral oxygen saturation will be monitored with near-infrared spectroscopy.
Time frame: The surgery day
Blood inflammatory factors
Arterial blood (4 mL) will be collected from patients during surgery, and blood inflammatory factors will be measured.
Time frame: The surgery day
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