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Area of Science:

  • Geriatric Medicine
  • Anesthesiology
  • Neuroscience

Background:

  • Postoperative delirium is a significant concern in surgical patients, leading to adverse outcomes.
  • It increases mortality, prolongs hospital stays, and elevates healthcare costs.
  • Effective interventions to prevent delirium are crucial for improving patient recovery.

Purpose of the Study:

  • To test the hypothesis that intravenous caffeine administration can reduce the incidence of delirium in older adults post-major non-cardiac surgery.
  • To evaluate the efficacy of different caffeine dosages (1.5 mg/kg and 3 mg/kg) compared to placebo.
  • To explore the impact of caffeine on delirium severity, duration, and patient-reported outcomes.

Main Methods:

  • The CAffeine, Postoperative Delirium And CHange In Outcomes after Surgery-2 (CAPACHINOS-2) Trial is a quadruple-blinded, randomized clinical trial.
  • 250 patients will be allocated in a 1:1:1 ratio to receive placebo, 1.5 mg/kg caffeine, or 3 mg/kg caffeine intravenously.
  • Delirium incidence will be assessed using the Confusion Assessment Method; secondary outcomes include delirium severity and patient-reported outcomes. A substudy will use electroencephalography to investigate neural abnormalities.

Main Results:

  • This section is not yet available as the trial is ongoing.
  • The primary outcome is the incidence of delirium, assessed via the Confusion Assessment Method.
  • Secondary outcomes include delirium severity, duration, patient-reported outcomes, and opioid consumption.

Conclusions:

  • This trial will provide critical data on the potential of intravenous caffeine as a prophylactic agent against postoperative delirium in older adults.
  • Findings may inform clinical practice guidelines for delirium prevention strategies.
  • The study will contribute to a better understanding of the neurobiological underpinnings of delirium through electroencephalography analysis.