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This prospective observational study aims to evaluate the effects of target-controlled infusion (TCI) on postoperative neurocognitive function in geriatric patients undergoing major non-cardiac surgery. Elderly patients are at increased risk of postoperative cognitive dysfunction due to physiological changes and anesthesia-related factors. In this study, sedation management with TCI will be compared to manual infusion. Neurocognitive function will be assessed at multiple time points using the Mini-Mental State Examination (MMSE), and sedation levels will be monitored with the Bispectral Index (BIS) and the Richmond Agitation-Sedation Scale (RASS). The study aims to provide insights into safer sedation practices and improved cognitive outcomes in elderly surgical patients.
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| Label | Type | Description | Intervention Names |
|---|---|---|---|
| TCI Group | Patients receiving postoperative sedoanalgesia with Target-Controlled Infusion (TCI). Sedation and analgesia were maintained using a target-controlled infusion system adjusted according to BIS and RASS monitoring. | ||
| Manual Infusion Group | Patients receiving postoperative sedoanalgesia with manually adjusted infusion without TCI. Sedation and analgesia were titrated manually based on BIS and RASS monitoring. |
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| Measure | Description | Time Frame |
|---|---|---|
| Change in neurocognitive function score (Mini-Mental State Examination,MMSE) | Between-group difference in the change of Mini-Mental State Examination (MMSE) total score from baseline to 72 hours after surgery, comparing target-controlled infusion (TCI) versus manual infusion. The MMSE is a widely used cognitive screening tool with a total score range of 0 to 30, where higher scores indicate better cognitive function. | Preoperative baseline (within 24 hours before anesthesia) to 72 hours postoperatively |
| Measure | Description | Time Frame |
|---|---|---|
| Total sedative and analgesic drug consumption | Total amount of sedative and analgesic medications administered during the postoperative sedation period in both groups (TCI vs manual infusion). Lower consumption may indicate more efficient sedation management. | From admission to the intensive care unit (ICU) until completion of the postoperative sedation period (approximately 0-72 hours postoperatively). |
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Inclusion Criteria:
Exclusion Criteria:
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Geriatric patients aged 65 years and older who undergo noncardiac, nonneurosurgical major surgery under general anesthesia and are monitored postoperatively in the intensive care unit. The study includes patients managed with either Target Controlled Infusion (TCI) or manual infusion for postoperative sedation and analgesia.
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| Name | Affiliation | Role |
|---|---|---|
| Namigar Turgut, MD | İstanbul Prof. Dr. Cemil Taşcıoğlu City Hospital | Principal Investigator |
| Zekeriya Ervatan, MD | İstanbul Prof. Dr. Cemil Taşcıoğlu City Hospital | Study Chair |
| Facility | Status | City | State | ZIP | Country | Contacts |
|---|---|---|---|---|---|---|
| İstanbul Prof. Dr. Cemil Taşcıoğlu City Hospital | Istanbul | Turkey (Türkiye) |
Individual participant data will not be shared due to institutional and ethical restrictions.
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| ID | Term |
|---|---|
| D000079690 | Postoperative Cognitive Complications |
| D000377 | Agnosia |
| ID | Term |
|---|---|
| D011183 | Postoperative Complications |
| D010335 | Pathologic Processes |
| D013568 | Pathological Conditions, Signs and Symptoms |
| D060825 | Cognitive Dysfunction |
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| Hospital length of stay | Total duration of hospitalization from the day of surgery until the patient is medically ready for discharge. Comparisons will be made between the TCI and manual infusion groups to evaluate whether postoperative sedation method influences overall hospital stay. | From the day of surgery until hospital discharge (up to 40 days). |
| D003072 | Cognition Disorders |
| D019965 | Neurocognitive Disorders |
| D001523 | Mental Disorders |
| D010468 | Perceptual Disorders |
| D019954 | Neurobehavioral Manifestations |
| D009461 | Neurologic Manifestations |
| D009422 | Nervous System Diseases |
| D012816 | Signs and Symptoms |