Perioperative Cognitive Function - Dexmedetomidine and Cognitive Reserve

• Status: Completed
• Trial end date: 2014-05-01
• Target enrollment: 0
• Participant gender: All

Summary

Elderly patients who undergo anesthesia and non-cardiac surgery are subject to deterioration of brain function including the development of postoperative delirium (PD) and postoperative cognitive dysfunction (POCD). These disorders cause disability, distress for both patients and their families, are associated with other medical complications and account for significant additional health care costs. We currently use relatively primitive approaches to preventing and treating PD and POCD.

Dexmedetomidine is a drug used for sedation in critically ill patients that provides some pain relief and controls the bodies response to stress. The sedation produced by dexmedetomidine appears more similar to natural sleep than any other drug used for anesthesia and postoperative sedation. Data suggesting that dexmedetomidine can prevent delirium following cardiac surgery and the developing understanding of the causes of PD and POCD suggest that dexmedetomidine will be particularly effective.

• Phase: Phase 4
• Accepts Healthy Volunteers?: No

Details

• Lead Sponsor: Icahn School of Medicine at Mount Sinai
• Collaborator: National Institute on Aging (NIA)
• Treatments: Dexmedetomidine

Criteria

Inclusion Criteria:

• 68 and older

• elective major surgery under general anesthesia(major surgery is defined by a planned 2 day hospitalization)

• ASA physical status I-III

• capable and willing to consent

• MMSE > 20 (to exclude dementia)

Exclusion Criteria:

• Cardiac surgery

• Intracranial Surgery

• Emergency Surgery

• Patients with severe visual or auditory disorder/handicaps

• Illiteracy

• Patients with clinically significant Parkinson's Disease

• Patients not expected to be able to complete the 3 and 6 month postoperative tests

• Sick sinus syndrome without pacemaker

• Hypersensitivity to drug or class

• Current 2nd or 3rd degree AV block

• History of clinically significant bradycardia

• Contraindication to the use of an 2A-agonist

• Presence of a major psychiatric condition such as bipolar disorder, major depression, schizophrenia, or dementia

• ASA physical status IV or V