Key result
High-level mean arterial pressure targeting 90-100 mmHg will be compared to a low-level target of 60-70 mmHg to evaluate its efficacy in reducing postoperative delirium in elderly patients undergoing non-cardiothoracic surgery.
Why the study?
Does a high-level mean arterial pressure target (90-100 mmHg) reduce postoperative delirium and complications in elderly patients undergoing non-cardiothoracic surgery under general anesthesia compared to a low-level target (60-70 mmHg)?
RCT (n=322)
Open-label, assessor-blinded
Blocked randomization in a 1:1 ratio
Yes
Does a high-level mean arterial pressure target (90-100 mmHg) reduce postoperative delirium and complications in elderly patients undergoing non-cardiothoracic surgery under general anesthesia compared to a low-level target (60-70 mmHg)?
This trial protocol aims to determine if targeting a higher mean arterial pressure (90-100 mmHg) during general anesthesia reduces postoperative delirium and complications in elderly patients compared to a lower target (60-70 mmHg).
BACKGROUND: Intraoperative blood pressure (BP) is a concern in daily clinic anesthesia and contributes to the differences in clinical outcome. We conducted a randomized controlled trial (RCT) to compare the effect of high vs. low mean arterial pressure (MAP) levels on clinical outcomes and complications in elderly patients under general anesthesia (GA). METHODS: In this multicenter, randomized, parallel-controlled, open-label, assessor-blinded clinical trial, 322 patients aged more than 65 years will be randomized for a low-level MAP (60-70 mmHg) or high-level MAP (90-100 mmHg) during non-cardiothoracic surgery under GA. The primary outcome will be the incidence of postoperative delirium. The secondary outcomes will include the delirium duration days, intraoperative urine volume, intraoperative blood loss, specific postoperative complications, and all-cause 28-day mortality. DISCUSSION: Results of this trial will help clarify whether BP management is beneficial for elderly patients under GA and will make clear whether the effect of high-level MAP can reduce the postoperative complication compared to low-level MAP. TRIAL REGISTRATION: ClinicalTrials.gov, NCT02857153 . Registered on 15 July 2016.
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Hu et al. (2017) conducted an RCT in Non-cardiothoracic surgery under general anesthesia (n=322). High-level mean arterial pressure (MAP) vs. Low-level MAP (target 60-70 mmHg) was evaluated on Incidence of postoperative delirium within the 7-day period after surgery. High-level mean arterial pressure targeting 90-100 mmHg will be compared to a low-level target of 60-70 mmHg to evaluate its efficacy in reducing postoperative delirium in elderly patients undergoing non-cardiothoracic surgery.
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