Sujet(s)
Analgésie péridurale , Analgésiques morphiniques , Morphine , Douleur postopératoire , Chirurgie thoracique vidéoassistée , Humains , Douleur postopératoire/prévention et contrôle , Douleur postopératoire/traitement médicamenteux , Douleur postopératoire/étiologie , Analgésie péridurale/méthodes , Morphine/administration et posologie , Chirurgie thoracique vidéoassistée/méthodes , Analgésiques morphiniques/administration et posologie , Administration par voie orale , Femelle , Mâle , Résultat thérapeutique , Adulte d'âge moyen , Sujet âgé , Mesure de la douleur/méthodesSujet(s)
Analgésiques morphiniques , Rachianesthésie , Césarienne , Injections rachidiennes , Morphine , Douleur postopératoire , Humains , Césarienne/méthodes , Femelle , Rachianesthésie/méthodes , Morphine/administration et posologie , Grossesse , Injections rachidiennes/méthodes , Analgésiques morphiniques/administration et posologie , Douleur postopératoire/traitement médicamenteux , AdulteRÉSUMÉ
BACKGROUND: Postoperative delirium (POD) is a common complication that is characterized by acute onset of impaired cognitive function and is associated with an increased mortality, a prolonged duration of hospital stay, and additional healthcare expenditures. The incidence of POD in elderly patients undergoing laparoscopic radical colectomy ranges from 8 to 54%. Xenon has been shown to provide neuroprotection in various neural injury models, but the clinical researches assessing the preventive effect of xenon inhalation on the occurrence of POD obtained controversial findings. This study aims to investigate the effects of a short xenon inhalation on the occurrence of POD in elderly patients undergoing laparoscopic radical colectomy. METHODS/DESIGN: This is a prospective, randomized, controlled trial and 132 patients aged 65-80 years and scheduled for laparoscopic radical colectomy will be enrolled. The participants will be randomly assigned to either the control group or the xenon group (n = 66 in each group). The primary outcome will be the incidence of POD in the first 5 days after surgery. Secondary outcomes will include the subtype, severity, and duration of POD, postoperative pain score, Pittsburgh Sleep Quality Index (PQSI), perioperative non-delirium complications, and economic parameters. Additionally, the study will investigate the activation of microglial cells, expression of inflammatory factors in colon tissues, plasma inflammatory factors, and neurochemical markers. DISCUSSION: Elderly patients undergoing laparoscopic radical colectomy are at a high risk of POD, with delayed postoperative recovery and increased healthcare costs. The primary objective of this study is to determine the preventive effect of a short xenon inhalation on the occurrence of POD in these patients. TRIAL REGISTRATION: Chinese Clinical Trial Registry ChiCTR2300076666. Registered on October 16, 2023, http://www.chictr.org.cn .