Different Intraoperative Blood Pressure Management on Postoperative Cognitive Function in Tumor Patients（PRECISION）

Launched by ZHEJIANG CANCER HOSPITAL · Nov 29, 2024

Keywords

ClinConnect Summary

The PRECISION trial is studying how different ways of managing blood pressure during surgery can affect the brain function of cancer patients who are at high risk for stroke. Researchers want to see if keeping blood pressure at a higher level (MAP≥85 mmHg) during surgery can help reduce problems like confusion, memory issues, and serious complications like heart problems or strokes that might happen after surgery. Patients in the trial will be randomly placed into one of two groups: one that uses strict blood pressure management and another that uses standard blood pressure management.

To be eligible for this study, patients must be preparing for surgery to remove abdominal tumors and have multiple risk factors for stroke. They should have a higher likelihood of complications, as indicated by their health status. Participants will have their blood pressure closely monitored during surgery and will be followed up for 30 days afterward to check for any cognitive issues or serious complications. It's important to note that patients with certain severe health conditions or recent strokes will not be able to participate. If you're considering joining this trial, your doctor can provide more information and help determine if you qualify.

Gender

ALL

Eligibility criteria

• Inclusion Criteria:
• • 1. Patients with high-risk stroke (combined with 3 risk factors or more according to the stroke risk screening table)
• • 2. Patients who plan to undergo surgery for abdominal tumors (gynecological, urinary, hepatobiliary, and gastrointestinal tumors) under general anesthesia are expected to have surgery duration \>2 hours
• • 3. The ASA is rated as Class II or III
• • 4. Patients who underwent invasive arterial blood pressure monitoring before surgery signed informed consent
• Exclusion Criteria:
• • 1. Patients do not want to participate in the study
• • 2. Patients with severe heart disease (severe valvular disease, sick sinus syndrome, high atrioventricular block without pacemaker implantation), grade III or above Liver function impairment (Child-Pugh class C)
• • 3. Need kidney replacement therapy; New stroke \<3 months
• • 4. Emergency surgery
• • 5. Preoperative history of mental illness, epilepsy, Parkinson's disease, or myasthenia gravis
• • 6. Speech, vision, or hearing impairment that prevents completion of a cognitive function assessment
• • 7. Situations where strict blood pressure management is not appropriate, such as controlled hypotension during surgery.