EEG-Guided Analgesic Titration During General Anesthesia to Improve Early Neurocognitive Recovery in Older Patients

Conditions

• Postoperative Delirium

Eligibility Criteria

Sex

ALL

Age

60 Years - N/A

Healthy Volunteers

Accepted

Interventions

• Alpha Optimization — PROCEDURE
  Intraoperative oscillatory EEG alpha optimization involves real-time acquisition of oscillatory alpha power from the frontal EEG with individualized titration of sevoflurane and opioid.
• Emergence from anesthesia with Dexmedetomidine — BEHAVIORAL
  Infusion of .05 mcg/kg/h of propofol during the final 10-20 minutes of surgery.

Study Details

The investigators intend to recruit 600 participants to see if alpha power during anesthesia is influenced by analgesic medication and associated with a reduction of delirium following surgery.

Key Dates

Start date

Apr 1, 2026

Status verified

Jan 2026

Primary completion

Jun 1, 2030

Completion

Mar 31, 2031

Study Design

Enrollment

600 participants (estimated)

Allocation

RANDOMIZED

Intervention model

FACTORIAL

Primary purpose

TREATMENT

Arms

• Experimental: Maintenance-Alpha Optimization / Wake from Dexmedetomidine
  During the first randomization, participants randomized to intraoperative oscillatory EEG alpha optimization will receive individualized titration of anesthetic gas and opioids.
• Active Comparator: Maintenance-Alpha Optimization / Wake from Sevoflurane
  During the first randomization, participants randomized to intraoperative oscillatory EEG alpha optimization will receive real-time monitoring of alpha recordings and individualized titration of desflurane and opioid. During the second randomization, participants randomized to standard emergence from volatile anesthesia will be woken up per standard practice.
• Active Comparator: Maintenance-Routine Care / Wake from Dexmedetomidine
  During the first randomization, participants randomized to standard of care will receive anesthesia per usual care with quantitative processed EEG index values and EEG wave forms.
• No Intervention: Maintenance-Routine Care / Wake from Sevoflurane
  During the first randomization, participants randomized to standard of care will receive anesthesia per usual care with quantitative processed EEG index values and EEG wave forms. During the second randomization, participants randomized to standard emergence from volatile anesthesia will be woken up per standard practice.

Primary Outcome Measure

Change in Frontal Alpha Power [ Time Frame: Up to 24 hours post-surgery ]

Central Contacts

• Paul S. Garcia, MD, PhD
  212-304-7678
  [email protected]
• Tuan Z. Cassim, BA
  917-539-9926
  [email protected]

Locations (1)

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