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Brief summary: In order to get a better clinical plan for brain protection during perioperative anesthesia for high-risk patients - carotid intima stripped. We observing the hemodynamic changes of sevoflurane post-treatment in carotid intima stripped, the comparison of postoperative cognitive function and postoperative radiographic changes.
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| Label | Type | Description | Intervention Names |
|---|---|---|---|
| Sevoflurane post conditioning group（S1） | Experimental | propofol：0.05～0.1mg/(kg.min) maintain throughout the whole surgery ,1% sevoflurane plus after open Carotid artery until the end of surgery |
|
| The control group（P） | No Intervention | propofol：0.05～0.1mg/(kg.min) maintain throughout the whole surgery without sevoflurane |
| Name | Type | Description | Arm Group Labels | Other Names |
|---|---|---|---|---|
| Sevoflurane inhalant product | Drug | propofol plus 1% sevoflurane after open Carotid artery until the end of surgery |
|
| Measure | Description | Time Frame |
|---|---|---|
| Change from the 1 day preoperative to the 1 day postoperative MMSE(Mini-mental State Examination) | Screening scale of cognitive function。The highest score is 30 points, 27 to 30 were divided into normal, less than 27 divided into cognitive dysfunction。But is not sensitive in the early identification of dementia, especially in mild cognitive impairment is poorer. | the 1st day before the surgery；the 1st day after the surgery |
| Change from the 1 day preoperative to the 1 day postoperative MoCA(Montreal Cognitive Assessment) | Screening scale of cognitive function。The highest score is 30 points，Add 1 score, education the following subjects in less than 12 years。Total score less than 26 divided into cognitive dysfunction。Compared with MMSE, more sensitive to mild dementia。 | Time Frame: the 1st day before the surgery；the 1st day after the surgery |
| Measure | Description | Time Frame |
|---|---|---|
| Heart rate | Heart rate per minute | Ten minutes before induction（T0) ,Intraoperative (Before the carotid artery occlusion（T1）), Intraoperative (before open the Carotid artery（T2)，At the end of the surgery when the surgeon completed sewing skin（T3），the 24 hours after the operation（T4） |
| Invasive arterial blood pressure |
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Inclusion Criteria:
Exclusion Criteria:
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| Name | Role | Phone | Extension | |
|---|---|---|---|---|
| Wang Bin, master | Contact | +8618806509509 | 381930860@qq.com |
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| Facility | Status | City | State | ZIP | Country | Contacts |
|---|---|---|---|---|---|---|
| 2nd Affiliated Hospital, School of Medicine, Zhejiang University | Recruiting | Hangzhou | Zhejiang | China |
| PubMed Identifier | Type | Citation | Retractions |
|---|---|---|---|
| 41438154 | Derived | Wang B, Li S, Wang C, Zhu J, Jin Y, Sun D, Lang J. Effect of sevoflurane post-conditioning on postoperative cognitive function in carotid endarterectomy patients: a randomized, double-blind, controlled trial. Front Med (Lausanne). 2025 Dec 8;12:1716370. doi: 10.3389/fmed.2025.1716370. eCollection 2025. |
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Invasive arterial puncture catheter, continuous arterial pressure monitoring |
| Ten minutes before induction（T0) ,Intraoperative (Before the carotid artery occlusion（T1）), Intraoperative (before open the Carotid artery（T2)，At the end of the surgery when the surgeon completed sewing skin（T3），the 24 hours after the operation（T4） |
| BIS | bispectral index | Ten minutes before induction（T0) ,Intraoperative (Before the carotid artery occlusion（T1）), Intraoperative (before open the Carotid artery（T2)，At the end of the surgery when the surgeon completed sewing skin（T3），the 24 hours after the operation（T4） |
| PETCO2 | Partial pressure End-Tidal Carbon Dioxide | Ten minutes before induction（T0) ,Intraoperative (Before the carotid artery occlusion（T1）), Intraoperative (before open the Carotid artery（T2)，At the end of the surgery when the surgeon completed sewing skin（T3），the 24 hours after the operation（T4） |
| Cerebral oxygen saturation | Cerebral oxygen saturation | Ten minutes before induction（T0) ,Intraoperative (Before the carotid artery occlusion（T1）), Intraoperative (before open the Carotid artery（T2)，At the end of the surgery when the surgeon completed sewing skin（T3），the 24 hours after the operation（T4） |
| 2nd Affiliated Hospital, School of Medicine, Zhejiang University | Recruiting | Hangzhou | Zhejiang | China |
|
| ID | Term |
|---|---|
| D000079690 | Postoperative Cognitive Complications |
| ID | Term |
|---|---|
| D011183 | Postoperative Complications |
| D010335 | Pathologic Processes |
| D013568 | Pathological Conditions, Signs and Symptoms |
| D060825 | Cognitive Dysfunction |
| D003072 | Cognition Disorders |
| D019965 | Neurocognitive Disorders |
| D001523 | Mental Disorders |
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