Imperial College London
Alternate

Professor Daqing Ma, MD, PhD

Faculty of Medicine, Department of Surgery & Cancer

Professor of Anaesthesia
 
 
 
//

Contact

 

+44 (0)20 3315 8495d.ma Website

 
 
//

Assistant

 

Miss Steffi Klier +44 (0)20 3315 8816

 
//

Location

 

G3.44Chelsea and Westminster HospitalChelsea and Westminster Campus

//

Summary

 

Publications

Citation

BibTex format

@article{Cao:2023:10.1016/j.bja.2023.04.024,
author = {Cao, S-J and Zhang, Y and Zhang, Y-X and Zhao, W and Pan, L-H and Sun, X-D and Jia, Z and Ouyang, W and Ye, Q-S and Zhang, F-X and Guo, Y-Q and Ai, Y-Q and Zhao, B-J and Yu, J-B and Liu, Z-H and Yin, N and Li, X-Y and Ma, J-H and Li, H-J and Wang, M-R and Sessler, DI and Ma, D and Wang, D-X and First, Study of Perioperative Organ Protection SPOP1 investigators},
doi = {10.1016/j.bja.2023.04.024},
journal = {Br J Anaesth},
pages = {253--265},
title = {Delirium in older patients given propofol or sevoflurane anaesthesia for major cancer surgery: a multicentre randomised trial.},
url = {http://dx.doi.org/10.1016/j.bja.2023.04.024},
volume = {131},
year = {2023}
}
Download

RIS format (EndNote, RefMan)

TY  - JOUR
AB  - BACKGROUND: Delirium is a common and disturbing postoperative complication that might be ameliorated by propofol-based anaesthesia. We therefore tested the primary hypothesis that there is less delirium after propofol-based than after sevoflurane-based anaesthesia within 7 days of major cancer surgery. METHODS: This multicentre randomised trial was conducted in 14 tertiary care hospitals in China. Patients aged 65-90 yr undergoing major cancer surgery were randomised to either propofol-based anaesthesia or to sevoflurane-based anaesthesia. The primary endpoint was the incidence of delirium within 7 postoperative days. RESULTS: A total of 1228 subjects were enrolled and randomised, with 1195 subjects included in the modified intention-to-treat analysis (mean age 71 yr; 422 [35%] women); one subject died before delirium assessment. Delirium occurred in 8.4% (50/597) of subjects given propofol-based anaesthesia vs 12.4% (74/597) of subjects given sevoflurane-based anaesthesia (relative risk 0.68 [95% confidence interval {CI}: 0.48-0.95]; P=0.023; adjusted relative risk 0.59 [95% CI: 0.39-0.90]; P=0.014). Delirium reduction mainly occurred on the first day after surgery, with a prevalence of 5.4% (32/597) with propofol anaesthesia vs 10.7% (64/597) with sevoflurane anaesthesia (relative risk 0.50 [95% CI: 0.33-0.75]; P=0.001). Secondary endpoints, including ICU admission, postoperative duration of hospitalisation, major complications within 30 days, cognitive function at 30 days and 3 yr, and safety outcomes, did not differ significantly between groups. CONCLUSIONS: Delirium was a third less common after propofol than sevoflurane anaesthesia in older patients having major cancer surgery. Clinicians might therefore reasonably select propofol-based anaesthesia in patients at high risk of postoperative delirium. CLINICAL TRIAL REGISTRATION: Chinese Clinical Trial Registry (ChiCTR-IPR-15006209) and ClinicalTrials.gov (NCT02662257).
AU  - Cao,S-J
AU  - Zhang,Y
AU  - Zhang,Y-X
AU  - Zhao,W
AU  - Pan,L-H
AU  - Sun,X-D
AU  - Jia,Z
AU  - Ouyang,W
AU  - Ye,Q-S
AU  - Zhang,F-X
AU  - Guo,Y-Q
AU  - Ai,Y-Q
AU  - Zhao,B-J
AU  - Yu,J-B
AU  - Liu,Z-H
AU  - Yin,N
AU  - Li,X-Y
AU  - Ma,J-H
AU  - Li,H-J
AU  - Wang,M-R
AU  - Sessler,DI
AU  - Ma,D
AU  - Wang,D-X
AU  - First,Study of Perioperative Organ Protection SPOP1 investigators
DO  - 10.1016/j.bja.2023.04.024
EP  - 265
PY  - 2023///
SP  - 253
TI  - Delirium in older patients given propofol or sevoflurane anaesthesia for major cancer surgery: a multicentre randomised trial.
T2  - Br J Anaesth
UR  - http://dx.doi.org/10.1016/j.bja.2023.04.024
UR  - https://www.ncbi.nlm.nih.gov/pubmed/37474241
VL  - 131
ER  -
Download