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The use of desflurane in elderly subjects (>65 years old) undergoing general anesthesia with endotracheal intubation will result in decreased POCD compared to sevoflurane if the patient's MAP is within 20% of the patient's baseline and the cerebral suppression state index stays within the moderately anesthetized range during general anesthesia.
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| Label | Type | Description | Intervention Names |
|---|---|---|---|
| desflurane and sevoflurane | Subjects will be randomized to either desflurane or sevoflurane. They will be given the Mini Mental State exam at 1, 6 and 24 hours after the end of anesthesia. |
|
| Name | Type | Description | Arm Group Labels | Other Names |
|---|---|---|---|---|
| The intervention will be Mini-Mental Status Examination (MMSE) | Other | A questionnaire given to the study patient before and after the anesthetic at 1, 6 and 24 hours. |
|
| Measure | Description | Time Frame |
|---|---|---|
| POCD in Elderly Patients Following Desflurane or Sevoflurane General Anesthesia | The primary outcome measure will be changes in cognitive function after anesthesia as measured by MMSE. | Both groups will complete the MMSE at 1, 6, and 24 hours after the end of anesthesia or to disharge up to 7 days. |
| Measure | Description | Time Frame |
|---|---|---|
| Secondary outcome measures will include: 1) time to extubation, anesthetic complications (e.g. coughing during extubation), 2) time to readiness for discharge from PACU, 3) length of hospital stay, and 4) any postoperative complications. | 24 hours to 7 days |
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Inclusion Criteria:
Exclusion Criteria:
Pre-existing significant psychiatric disease or mental status changes
Clinically significant cardiovascular, respiratory, hepatic, renal,neurological, psychiatric, or metabolic disease
Patient's weighing >50% ideal body weight
Patients who have undergone a general anesthetic within the past 7 days
Patient refusal
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Adult patients, male and female, 65 years or older scheduled for elective surgery requiring general anesthesia.
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| Facility | Status | City | State | ZIP | Country | Contacts |
|---|---|---|---|---|---|---|
| Loma Linda University | Loma Linda | California | 92354 | United States |
| PubMed Identifier | Type | Citation | Retractions |
|---|---|---|---|
| 24666542 | Derived | Meineke M, Applegate RL 2nd, Rasmussen T, Anderson D, Azer S, Mehdizadeh A, Kim A, Allard M. Cognitive dysfunction following desflurane versus sevoflurane general anesthesia in elderly patients: a randomized controlled trial. Med Gas Res. 2014 Mar 25;4(1):6. doi: 10.1186/2045-9912-4-6. |
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