NCT03133845

Shaping Anesthetic Techniques to Reduce Post-operative Delirium

Shaping Anesthetic Techniques to Reduce Post-Operative Delirium

• Status: Completed
• Phase: N/A
• Study type: Interventional
• Enrollment: 218 (estimated)
• Sponsor: Johns Hopkins University · Academic / Other
• Sex: All
• Age: 65 Years
• Healthy volunteers: Not accepted

Summary

The purpose of this study is to determine if light sedation with spinal anesthesia reduces the incidence of delirium compared to receiving general anesthesia during spinal surgery in older adults.

Detailed description

Post-operative delirium is a common occurrence in older adults. Post -operative delirium has been associated with cognitive decline after hospitalization. Developing perioperative management strategies to prevent delirium may also reduce potential cognitive decline in older adults after surgery. The choice and dose of anesthetic and sedative drugs are known risk factors in the development of delirium. Excessive doses of anesthetic and sedation drugs during surgery have been associated with poor outcomes that occur after surgery. Currently depth of anesthesia can be measured by an additional monitoring technique called Bispectral Index (BIS). The purpose of this study is to determine if light sedation with spinal anesthesia reduces the incidence of delirium compared to receiving general anesthesia during spinal surgery in older adults. Previous studies have shown that using light sedation and spinal anesthesia during surgery may reduce the incidence of delirium up to 50%.

Conditions

• Delirium
• Lumbar Radiculopathy
• Lumbar Osteoarthritis
• Lumbar Spine Disc Degeneration

Interventions

Type	Name	Description
PROCEDURE	Light sedation with propofol	Patients having lumbar spinal surgery and receiving spinal anesthesia will receive propofol for light sedation.
PROCEDURE	Induction with propofol	Patients having lumbar spinal surgery and receiving general anesthesia will receive propofol and their induction agent.
PROCEDURE	Maintenance anesthetic using a volatile anesthetic	Patients having lumbar spinal surgery and receiving general anesthesia will receive a volatile anesthetic for their maintenance anesthesia.
PROCEDURE	Muscle relaxant during maintenance anesthesia	Patients having lumbar spinal surgery and receiving general anesthesia with receive a muscle relaxant for muscle paralysis.
PROCEDURE	Pain control with fentanyl	Patients having lumbar spinal surgery and receiving general anesthesia will receive fentanyl for their pain during surgery.
PROCEDURE	Bispectral Index (BIS) monitoring for depth of anesthesia	All patients will be monitored with Bispectral Index (BIS) to monitor the patient's depth of anesthesia.
PROCEDURE	Spinal Anesthesia	Patients receiving spinal anesthesia will receive bupivacaine into the subarachnoid space.
PROCEDURE	Midazolam administered during spinal anesthesia	Midazolam may be administered during spinal needle insertion for patients receiving spinal anesthesia.
PROCEDURE	Cerebrospinal fluid collection	8 ml of cerebrospinal fluid may be collected prior to the administration of intrathecal administration of morphine for pain control.
PROCEDURE	Administration of intrathecal morphine	Patient may receive intrathecal morphine for post-operative pain control.

Timeline

• Start date: 2015-10-01
• Primary completion: 2020-05-25
• Completion: 2020-05-25
• First posted: 2017-04-28
• Last updated: 2020-06-18

Locations

1 site across 1 country: United States