Depth of Anesthesia on Postoperative Delirium and Cognitive After Surgery

Launched by AUCKLAND CITY HOSPITAL · Feb 13, 2024

Keywords

ClinConnect Summary

The Balanced-2 study is a clinical trial aimed at understanding how different levels of anesthesia—light versus deep—affect older adults after major surgery. Researchers are particularly interested in whether using lighter anesthesia can help reduce the risk of delirium, which is a common and serious complication that can lead to confusion and longer hospital stays. Delirium affects many older patients, and finding ways to prevent it is important for maintaining their brain health and overall well-being.

To participate in this trial, individuals must be aged 65 and older, or 55 and older if they are from Indigenous or Pacific backgrounds, and they should be scheduled for major surgery that is expected to last at least two hours. Participants will be randomly assigned to receive either lighter or deeper anesthesia during their procedure, and their recovery will be monitored to see if they experience delirium and any long-term cognitive or physical decline. This study could lead to better care for older adults undergoing surgery, ultimately helping to preserve their health and reduce healthcare costs.

Gender

ALL

Eligibility criteria

• Inclusion Criteria:
• • Patients aged ≥ 65 years, and Māori, Pacific or Indigenous participants aged ≥ 55 years who are undergoing major elective or non-elective surgery with expected surgical duration ≥ 2 hours and postoperative hospital stay ≥ 2 nights.
• • Having general anesthesia using total intravenous anesthesia (TIVA) with pEEG monitoring
• • Able to provide informed consent (including patients with mild preoperative neurocognitive disorders)
• Exclusion Criteria:
• • Intracranial or cardiac surgery
• • Undergoing surgery with 'wake up' test
• • Previous enrollment in Balanced-2 study
• • Terminal illness with expected survival \<3 months
• • Emergency surgery within 6 hours of presentation to hospital
• • Cognitive impairment with no capacity to consent or activated enduring power of attorney
• • Clinically impaired and unable to consent due to acute pathology or preoperative delirium