Optimized Anesthesia to Reduce Incidence of Postoperative Delirium

Optimized Anesthesia to Reduce Incidence of Postoperative Delirium in Elderly Undergoing Elective, Non-cardiac Surgery: a Randomized Controlled Trial (POD-II)

The purpose of this study is to compare the difference of incidence of postoperative delirium between patients received general anesthesia guided by Bispectral index (BIS) and patients received general anesthesia using standard technique.

General anesthesia is one of precipitating factor of postoperative delirium which Its mechanism is still unknown. General anesthesia can affect on pattern of electroencephalograph. Previous studies showed that patients received BIS guided anesthesia could wake up faster, earlier extubation and stay in recovery room shorter compared to standard general anesthesia. Optimized level of anesthesia by BIS could reduce cognitive dysfunction in elderly patients and reduce biological marker of brain injury. Therefore, the investigators hypothesized that adjustment of general anesthesia by BIS guided could protect central nervous system and reduce incidence of postoperative delirium.

Inclusion Criteria:

• Patients age equal or more than 65 years.
• Patients undergoing general anesthesia.
• Patients undergoing scheduled, non-cardiac surgery

Exclusion Criteria:

• Patients undergoing neurosurgery.
• Patients cannot understand Thai language.
• Patients who have severe visual or hearing impairment.