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BMC Anesthesiology
Published in: BMC Anesthesiology 1/2015

Open Access 01-12-2015 | Study protocol

Effects of two different anesthesia-analgesia methods on incidence of postoperative delirium in elderly patients undergoing major thoracic and abdominal surgery: study rationale and protocol for a multicenter randomized controlled trial

Authors: Ya-Wei Li, Hui-Juan Li, Huai-Jin Li, Yi Feng, Yao Yu, Xiang-Yang Guo, Yan Li, Bin-Jiang Zhao, Xiao-Yun Hu, Ming-Zhang Zuo, Hong-Ye Zhang, Mei-Rong Wang, Ping Ji, Xiao-Yan Yan, Yang-Feng Wu, Dong-Xin Wang

Published in: BMC Anesthesiology | Issue 1/2015

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Abstract

Background

Delirium is a common complication in elderly patients after surgery and associated with increased morbidity and mortality. Studies suggest that deep anesthesia and intense pain are important precipitating factors of postoperative delirium. Neuraxial block is frequently used in combination with general anesthesia for patients undergoing major thoracic and abdominal surgery. Compared with general anesthesia alone and postoperative intravenous analgesia, combined epidural-general anesthesia and postoperative epidural analgesia decreases the requirement of general anesthetics during surgery and provided better pain relief after surgery. However, whether combined epidural-general anesthesia plus epidural analgesia is superior to general anesthesia plus intravenous analgesia in decreasing the incidence of postoperative delirium remains unknown.

Methods/design

This is a multicenter, open-label, randomized, parallel-controlled clinical trial. One thousand eight hundred elderly patients (age range 60–90 years) who are scheduled to undergo major thoracic or abdominal surgery are randomized to receive either general anesthesia plus postoperative intravenous analgesia or combined epidural-general anesthesia plus postoperative epidural analgesia. The primary outcome is the 7-day incidence of postoperative delirium. Secondary outcomes include the duration of postoperative delirium, the intensity of pain during the first three days after surgery, the 30-day incidences of postoperative non-delirium complications, the length of stay in hospital after surgery and 30-day all-cause mortality.

Discussion

Results of the present study will provide information to guide clinical practice in choosing appropriate anesthesia-analgesia method for elderly patients undergoing major thoracic and abdominal surgery.

Trial registration

The study is registered on ClinicalTrials.gov NCT01661907 and Chinese Clinical Trial Registry ChiCTR-TRC-12002371.
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Metadata
Title
Effects of two different anesthesia-analgesia methods on incidence of postoperative delirium in elderly patients undergoing major thoracic and abdominal surgery: study rationale and protocol for a multicenter randomized controlled trial
Authors
Ya-Wei Li
Hui-Juan Li
Huai-Jin Li
Yi Feng
Yao Yu
Xiang-Yang Guo
Yan Li
Bin-Jiang Zhao
Xiao-Yun Hu
Ming-Zhang Zuo
Hong-Ye Zhang
Mei-Rong Wang
Ping Ji
Xiao-Yan Yan
Yang-Feng Wu
Dong-Xin Wang
Publication date
01-12-2015
Publisher
BioMed Central
Published in
BMC Anesthesiology / Issue 1/2015
Electronic ISSN: 1471-2253
DOI
https://doi.org/10.1186/s12871-015-0118-5

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