Overview

Perioperative Multimodal General AnesTHesia Focusing on Specific CNS Targets in Patients Undergoing carDiac surgERies - the PATHFINDER II Study

Status:
Not yet recruiting
Trial end date:
2023-09-01
Target enrollment:
0
Participant gender:
All
Summary
In the PATHFINDER 2 trial, we will test our intraoperative EEG-guided multimodal general anesthesia (MMGA) management strategy in combination with a postoperative protocolized analgesic approach to: 1. ensure hemodynamic stability and decrease use of vasopressors in the operating rooms 2. reduce pain and opioid consumption postoperatively 3. reduce the incidence of perioperative neurocognitive dysfunction in cardiac surgical patients
Phase:
N/A
Accepts Healthy Volunteers?
No
Details
Lead Sponsor:
Beth Israel Deaconess Medical Center
Treatments:
Dexmedetomidine
Ketamine
Propofol
Remifentanil
Rocuronium
Ropivacaine
Criteria
Inclusion Criteria:

- Age ≥ 60 years

- Undergoing any of the following types of surgery with cardiopulmonary bypass limited
to coronary artery bypass surgery (CABG), CABG+valve surgeries and isolated valve
surgeries.

Exclusion Criteria:

- Preoperative left ventricular ejection fraction (LVEF) <30%

- Emergent surgery

- Non-English speaking

- Cognitive impairment as defined by total MoCA score < 10

- Currently enrolled in another interventional study that could impact the primary
outcome, as determined by the PI

- Significant visual impairment

- Chronic opioid use for chronic pain conditions with tolerance (total dose of an opioid
at or more than 30 mg morphine equivalent for more than one month within the past
year)

- Hypersensitivity to any of the study medications

- Known history of alcohol (> 2 drinks per day) or drug abuse Active (in the past year)
history of alcohol abuse (≥5 drinks/day for men or ≥4 drinks/day for women) as
determined by reviewing medical record and history given by the patient

- Liver dysfunction (liver enzymes > 4 times the baseline, all patients will have a
baseline liver function test evaluation), history and examination suggestive of
jaundice.