Turkish Precision Anaesthesia Study Project

NCT ID: NCT05872529

Last Updated: 2023-05-24

Study Results

Results pending

The study team has not published outcome measurements, participant flow, or safety data for this trial yet. Check back later for updates.

Basic Information

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Recruitment Status

UNKNOWN

Clinical Phase

NA

Total Enrollment

2200 participants

Study Classification

INTERVENTIONAL

Study Start Date

2023-07-31

Study Completion Date

2025-07-31

Brief Summary

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Postoperative delirium (POD) and postoperative neurocognitive disorder (PND) increase the length of hospital stay, morbidity and mortality, especially in elderly patients. Although several risk factors were determined and incidence trials were performed on the development of POD and PND, there has not yet been a multicentre, large-participant study in Turkish population. The SBI approach monitor, detect and help physicians and all perioperative team members to decrease and avoid the adverse side effects of surgery and anaesthesia. In this "before and after" design trial the incidence of POD and PND will be compared before and after education which consists processed EEG and SBI approach.

The primary aim of the study is to determine the effect of education which consists processed EEG monitoring and regularly assessment of patient's stress, anxiety, pain, nausea, vomiting, thirst, hunger and better communication at the pre- and postoperative period on the incidence of POD. The secondary aim of the study is to assess the effect of the Safe Brain Initiative approach on patients' thirst feeling, stress-anxiety levels, postoperative pain, postoperative nausea and vomiting, well-being, satisfaction, length of PACU or recovery room stay, length of hospital stay, incidence of PND and in hospital and 3-month mortality. Also, the physicians', nurses' and patients satisfaction will be assessed.

Detailed Description

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Postoperative delirium (POD) and postoperative neurocognitive disorder (PND) increase the length of hospital stay, morbidity and mortality, especially in elderly patients. Although several risk factors were determined and incidence trials were performed on the development of POD and PND, there has not yet been a multicentre, large-participant study in Turkish population. The EJA guideline recommends depth of anaesthesia monitoring, especially in frail patients since intraoperative burst suppression increases the risk of PND. American guideline emphasizes that the effect of processed EEG monitoring on POD cannot be fully demonstrated, but it may reduce PND. Yet, processed EEG monitors, when simplified to an index number, may not accurately reflect the depth of anaesthesia. To detect vulnerable patients, EEG training can be easily implemented. Thus, the incidence of POD and PND may decrease.

Additionally, not just EEG monitoring but also regular assessment of patients' stress, anxiety, pain, nausea, vomiting, thirst, and hunger during the pre-and postoperative period and better communication with the patients would reduce the risk of POD. That's why we will use the Safe Brain Initiative (SBI) approach. The SBI approach monitor, detect and help physicians and all perioperative team members to decrease and avoid the adverse side effects of surgery and anaesthesia. In this "before and after" design trial the incidence of POD and PND will be compared before and after education which consists processed EEG and SBI approach.

The primary aim of the study is to determine the effect of education which consists processed EEG monitoring and regularly assessment of patient's stress, anxiety, pain, nausea, vomiting, thirst, hunger and better communication at the pre- and postoperative period on the incidence of POD. The secondary aim of the study is to assess the effect of the Safe Brain Initiative approach on patients' thirst feeling, stress-anxiety levels, postoperative pain, postoperative nausea and vomiting, well-being, satisfaction, length of PACU or recovery room stay, length of hospital stay, incidence of PND and in hospital and 3-month mortality. Also, the physicians', nurses' and patients satisfaction will be assessed.

Conditions

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Delirium Neurocognitive Disorders

Study Design

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Allocation Method

NON_RANDOMIZED

Intervention Model

SEQUENTIAL

Before and After model
Primary Study Purpose

SCREENING

Blinding Strategy

SINGLE

Outcome Assessors

Study Groups

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BEFORE

The incidence of the POD and PND will determine before the education which consists processed EEG monitoring and SBI approach

Group Type NO_INTERVENTION

No interventions assigned to this group

AFTER

The incidence of the POD and PND will determine after the education which consists processed EEG monitoring and SBI approach

Group Type ACTIVE_COMPARATOR

Education

Intervention Type BEHAVIORAL

The education which consists processed EEG monitoring and SBI approach

Interventions

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Education

The education which consists processed EEG monitoring and SBI approach

Intervention Type BEHAVIORAL

Eligibility Criteria

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Inclusion Criteria

* Patients over 18 years of age
* Patients who will scheduled for non-cardiac, non-cranial surgery under general anaesthesia
* Patients who will undergo intraoperative processed EEG monitoring

Exclusion Criteria

* Patients who will undergo outpatient, cardiac or intracranial surgery
* Patients undergoing surgery with regional anesthesia
* Alzheimer disease
* Psychiatric disorder
* Using antipsychotic drug
* Who will refuse to participate in study w
* Who scheduled for a second surgery within 3 months
* Who admitted to the ICU postoperatively with intubated and sedated
Minimum Eligible Age

18 Years

Eligible Sex

ALL

Accepts Healthy Volunteers

Yes

Sponsors

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Ankara University

OTHER

Sponsor Role collaborator

Marmara University

OTHER

Sponsor Role collaborator

Istanbul University - Cerrahpasa

OTHER

Sponsor Role collaborator

Acibadem University

OTHER

Sponsor Role collaborator

Cukurova University

OTHER

Sponsor Role collaborator

Saglik Bilimleri Universitesi

OTHER

Sponsor Role collaborator

Istanbul University

OTHER

Sponsor Role lead

Responsible Party

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Özlem Korkmaz Dilmen

Prof MD

Responsibility Role PRINCIPAL_INVESTIGATOR

Principal Investigators

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Ozlem Korkmaz Dilmen, Prof

Role: PRINCIPAL_INVESTIGATOR

Istanbul University- Cerrahpasa, Cerrahpasa Medical Faculty

Basak Ceyda Meco, Prof

Role: PRINCIPAL_INVESTIGATOR

Ankara University, Department of Anesthesiology and Intensive Care

Locations

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Istanbul University - Cerrahpasa, Department of Neurosurgery, Neurosurgical Theaters

Istanbul, , Turkey (Türkiye)

Site Status

Countries

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Turkey (Türkiye)

Central Contacts

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Özlem Korkmaz Dilmen, Prof

Role: CONTACT

00904143000 ext. 63913

References

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Sumner M, Deng C, Evered L, Frampton C, Leslie K, Short T, Campbell D. Processed electroencephalography-guided general anaesthesia to reduce postoperative delirium: a systematic review and meta-analysis. Br J Anaesth. 2023 Feb;130(2):e243-e253. doi: 10.1016/j.bja.2022.01.006. Epub 2022 Feb 17.

Reference Type RESULT
PMID: 35183345 (View on PubMed)

Evered L, Silbert B, Knopman DS, Scott DA, DeKosky ST, Rasmussen LS, Oh ES, Crosby G, Berger M, Eckenhoff RG; Nomenclature Consensus Working Group. Recommendations for the nomenclature of cognitive change associated with anaesthesia and surgery-2018. Br J Anaesth. 2018 Nov;121(5):1005-1012. doi: 10.1016/j.bja.2017.11.087. Epub 2018 Jun 15.

Reference Type RESULT
PMID: 30336844 (View on PubMed)

Kong H, Xu LM, Wang DX. Perioperative neurocognitive disorders: A narrative review focusing on diagnosis, prevention, and treatment. CNS Neurosci Ther. 2022 Aug;28(8):1147-1167. doi: 10.1111/cns.13873. Epub 2022 Jun 1.

Reference Type RESULT
PMID: 35652170 (View on PubMed)

Radtke FM, Franck M, Lendner J, Kruger S, Wernecke KD, Spies CD. Monitoring depth of anaesthesia in a randomized trial decreases the rate of postoperative delirium but not postoperative cognitive dysfunction. Br J Anaesth. 2013 Jun;110 Suppl 1:i98-105. doi: 10.1093/bja/aet055. Epub 2013 Mar 28.

Reference Type RESULT
PMID: 23539235 (View on PubMed)

Other Identifiers

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IREANET001

Identifier Type: -

Identifier Source: org_study_id

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