Anaesthetic Depth and Short Term Delirium Post Cardiac Surgery Intervention

• Status: Not yet recruiting
• Trial end date: 2025-05-10
• Target enrollment: 0
• Participant gender: All

Summary

Postoperative delirium (POD) is a critical complication of major surgery and affects up to 70% of surgical patients over the age of 60 years.

The additional healthcare costs associated with delirium exceed €50,000 per patient per year due to prolonged hospital stay, increased risk of long-term care or institutionalization, and the risk of developing dementia or cognitive impairment . Therefore, prevention of POD is a major goal in the perioperative setting.

The investigator proposes this randomized study to evaluate the interest of a reduced anesthetic depth to prevent short-term cognitive disorders after cardiac surgery in elderly subjects.

Method: Patients over 75 years old scheduled to undergo one of the cardiac surgeries of interest (valvular, coronary bypass, aortic or combined surgery) will be randomized to 2 paralell arms :

• Perioperative anesthesia with a BIS (Bispectral index) target of 35

• Perioperative anesthesia with a BIS(Bispectral index) target of 55

The presence of mental confusion will be determined by CAM-ICU ( Confusion Assessment Method for the ICU ) at day 3 post procedure.

Ancillary study: To assess cognitive status at inclusion, discharge and third post operative month using the MOCA(Montreal Cognitive Assessment ).

Conclusion:The hypothesis of this study is that a lower depth of anesthesia will reduce post operative delirium in the first three days in patients older than 75 years who are planned for valvular, coronary artery bypass, aortic or combined cardiac surgery .

• Phase: N/A
• Accepts Healthy Volunteers?: No

Details

• Lead Sponsor: Centre Cardiologique du Nord
• Treatments: Anesthetics; Propofol; Sevoflurane

Criteria

Inclusion Criteria:

• Patient aged between 75 and 85 years, who signed an informed consent, undergoing elective valvular, coronary artery bypass, aortic or combined cardiac surgery

• Be affiliated to French Health Insurance

Exclusion Criteria:

• Refusal of consent -Patient unable to read, write or understand French

• Vulnerable patient according to article L1121-6 of the CSP,

• Patient of legal age under guardianship or curatorship or under legal protection,

• Patient unable to give personal consent according to article L.1121-8 of the CSP or adult protected by law,

• Patient having already participated in the present study