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The Post-Anaesthesia N-acetylcysteine Cognitive Evaluation (PANACEA) trial: study protocol for a randomised
David R Skvarc1,2,3, Olivia M Dean2,3, Linda K Byrne1
1School of Psychology, Deakin University, 221 Burwood Highway, Burwood, 3215, VIC, Australia.
Trials
|August 10, 2016
Summary
This study investigates if N-acetylcysteine (NAC) can prevent cognitive decline after noncardiac surgery in older adults. The trial aims to determine NAC
Area of Science:
- Geriatric Medicine
- Neuroscience
- Surgical Outcomes
Background:
- Postoperative cognitive decline affects up to 25% of elderly surgical patients, increasing morbidity and mortality.
- Cognitive domains affected include memory, psychomotor skills, and executive function.
- Oxidative stress and neuroinflammation are implicated in postsurgical cognitive changes.
Purpose of the Study:
- To evaluate the efficacy of perioperative N-acetylcysteine (NAC) in mitigating postoperative cognitive dysfunction in elderly patients undergoing noncardiac surgery.
- To explore NAC's potential to reduce oxidative stress and inflammation markers post-surgery.
Main Methods:
- A single-centre, randomized, double-blind, placebo-controlled trial involving 370 elderly (≥60 years) noncardiac surgery patients.
- Participants received either NAC or placebo, stratified by age and surgery type.
- Neuropsychological tests were administered pre-surgery and at 7 days, 3 months, and 12 months post-surgery. Serum biomarkers of inflammation and oxidative stress were measured.
Main Results:
- Hypothesis: Perioperative NAC administration will reduce the severity of postoperative cognitive changes compared to placebo at early and long-term follow-ups.
- Biomarker analysis will quantify changes in inflammation and oxidative stress.
Conclusions:
- The PANACEA trial represents a novel approach to preventing postoperative cognitive dysfunction.
- Positive findings could offer a high-impact, translatable intervention for elderly surgical patients.
