Overview

Dexmedetomidine to Reduce the Incidence of POCD After Open Cardiac Surgery

Status:
Active, not recruiting
Trial end date:
2022-12-01
Target enrollment:
0
Participant gender:
All
Summary
Anesthesia is a drug induced, reversible, comatose state that facilitates surgery and it is widely assumed that cognition returns to baseline after anesthetics have been eliminated. However, many patients have persistent memory impairment for weeks to months after surgery. Cardiac surgery appears to carry the highest risk of postoperative cognitive dysfunction (POCD). These cognitive deficits are associated with increased mortality, prolonged hospital stay and loss of independence. The investigators propose to investigate the role of Dexmedetomidine (DEX) in preventing long-term POCD after cardiac surgery and enhancing early postoperative recovery. It is anticipated that DEX will be the first effective preventative therapy for POCD, improve patient outcomes, and reduce length of stay and healthcare costs.
Phase:
Phase 4
Accepts Healthy Volunteers?
No
Details
Lead Sponsor:
Sunnybrook Health Sciences Centre
Treatments:
Dexmedetomidine
Criteria
Inclusion Criteria:

- Planned CABG (including off-pump) or valve replacement (+/- CABG) via
sternotomy/thoracotomy, with initial recovery in the Cardiovascular Intensive Care
Unit (CVICU)

- age ≥60

Exclusion Criteria:

- Lack of patient consent

- Pregnant or nursing females

- Pre-operative major cognitive dysfunction (CogState Brief Battery score < 80)

- Aortic arch replacement/re-implantation (Bentalls)

- Allergy/contraindication to dexmedetomidine (untreated 2nd degree type 2 or 3rd degree
heart block (pacemaker), cirrhosis, HR < 50 , grade 4 LV, renal failure or on renal
replacement therapy)

- Unlikely to comply with study assessments (e.g. no fixed address, cannot complete
cognitive tests at the 3, 6, and 12 month timepoints)