Related Experiment Video

Updated: Sep 9, 2025

Author Spotlight: A Non-Intubated Video-Assisted Thoracoscopic Surgery with Multimodal Analgesia and Sevoflurane Inhalation Anesthesia

Author Spotlight: A Non-Intubated Video-Assisted Thoracoscopic Surgery with Multimodal Analgesia and Sevoflurane Inhalation Anesthesia

Published on: May 26, 2023

Anaesthetic depth and short-term delirium after cardiac surgery intervention: the study protocol of the BISCAR

Omar Ellouze¹, Elie Zogheib², Khoubeyb Abdelhafidh³

¹Department of Anesthesia and Critical Care, Centre Cardiologique du Nord, Saint-Denis, France ellouze.omar@yahoo.fr.

|August 28, 2025

Abstract

Introduction:

Perioperative cognitive disorders include three essential elements: the progression of a pre-existing neurocognitive lesion, the occurrence of postoperative delirium (POD) and, finally, a mild or severe postoperative neurocognitive disorder. These perioperative disorders are associated with increased morbidity and mortality. Numerous risk factors are associated with perioperative cognitive disorders, the most salient being advanced age and the type of surgery. Specifically, major surgeries and cardiac surgery with associated tissue injuries and inflammation are significant causes of these cognitive impairments. The depth of anaesthesia has recently emerged as an important risk factor for perioperative cognitive disorders, particularly in older patients. The aim of our study is to evaluate whether a reduction in anaesthesia depth is associated with perioperative cognitive disorders in patients aged over 75 years who undergo planned cardiac surgery.

Methods And Analysis:

This is a multicentric randomised controlled trial with the aim to investigate whether a lower level of anaesthesia evaluated with a Bispectral Index (35 vs 55) reduces the prevalence of POD in patients aged 75 years and over who undergo planned cardiac surgery (heart valve surgery, coronary artery bypass graft surgery, aortic surgery or combined surgery). 200 patients are planned for enrolment. The analysis evaluates the prevalence of delirium during the first 3 days after surgery with the Confusion Assessment Method for the Intensive Care Unit Scale.

Ethics And Dissemination:

The study protocol has been approved by the relevant French medical review board: the French Committee for Protection of Persons (ID: 2022-A02200-43, Comité de protection des personnes Est III). We plan to present the results at (inter)national conferences after the completion of the study and to publish them in peer-reviewed journals.

Trial Registration Number:

French Ethic Committee (ID: 2022-A02200-43) and ClinicalTrials.gov Registry (NCT05877326).

Keywords:

Cardiac surgery Delirium Delirium & cognitive disorders Electroencephalography Old age psychiatry

More Related Videos

Recording Brain Electromagnetic Activity During the Administration of the Gaseous Anesthetic Agents Xenon and Nitrous Oxide in Healthy Volunteers

Recording Brain Electromagnetic Activity During the Administration of the Gaseous Anesthetic Agents Xenon and Nitrous Oxide in Healthy Volunteers

Published on: January 13, 2018

Assessing Changes in Volatile General Anesthetic Sensitivity of Mice after Local or Systemic Pharmacological Intervention

Assessing Changes in Volatile General Anesthetic Sensitivity of Mice after Local or Systemic Pharmacological Intervention

Published on: October 16, 2013

Related Concept Videos

Stages of General Anesthesia

Stages of General Anesthesia

Various sedation levels offer significant advantages in facilitating procedural interventions for patients undergoing medical or invasive surgical procedures. These levels span from anxiolysis to general anesthesia, providing a spectrum of sedative effects to cater to specific patient needs. Anxiolysis reduces anxiety and is achieved through minimal sedation, enabling patients to remain awake and responsive while feeling more at ease during the procedure. This level can benefit minor...

General Anesthesia: Overview

General Anesthesia: Overview

Anesthesia is a medical procedure that uses drugs for CNS suppression to enable painless surgeries and procedures. The selection of anesthetics is influenced by their pharmacokinetic properties, side effects, and patient characteristics. Various types of anesthesia include general, local, regional, spinal, and inhalational.
General anesthesia induces unconsciousness in the whole body, while the others target specific areas or sensations. It is administered to minimize adverse effects, maintain...

Parenteral Anesthetics: Overview

Parenteral Anesthetics: Overview

Intravenous anesthetics are drugs administered parenterally to induce anesthesia or sedation. Propofol is a widely used agent formulated as a 1% emulsion in soybean oil, glycerol, and egg phosphatide. It induces rapid anesthesia primarily due to its rapid distribution from the bloodstream to target tissues and is metabolized in the liver. However, it can cause significant pain on injection and hypertriglyceridemia. Fospropofol, a water-based prodrug of propofol, lacks these adverse effects.

Inhalational Anesthetics: Overview

Inhalational Anesthetics: Overview

Inhalation anesthetics are drugs that induce general anesthesia upon inhalation. They work by increasing the sensitivity of GABAA receptors or inhibiting NMDA receptors, leading to a decrease in central nervous system activity. The depth of anesthesia can be rapidly adjusted by changing the concentration of the inhaled gas. Some common examples of inhalational anesthetics include volatile liquids like isoflurane, desflurane, sevoflurane and gases like xenon and nitrous oxide. Isoflurane, a...

Local Anesthetics: Clinical Application as Spinal Anesthesia

Local Anesthetics: Clinical Application as Spinal Anesthesia

Spinal anesthetics are given during lower abdomen and limb surgeries to block sensory and motor neurons. They are administered in the mid to low lumbar regions, primarily acting on the cauda equina's nerve roots. The blockade level depends on the local anesthetic (LA) concentration. Usually, low LA concentrations are sufficient to block sensory fibers, while only high LA concentrations block motor fibers. Other factors like injection volume and speed, the patient's posture, and the drug...

Local Anesthetics: Pharmacokinetics

Local Anesthetics: Pharmacokinetics

The potency and duration of action of local anesthetics (LAs) are determined by their pharmacokinetics. Pharmacokinetics describes how LAs are absorbed, distributed, metabolized, and eliminated from the body. When administered to the vascular tissues, LAs are quickly absorbed and enter the systemic circulation, reducing their localized effects. Adding vasoconstrictors such as epinephrine to LAs reduces their absorption into the systemic circulation, making them clinically effective. The...

Articles linked to this work by shared authors, journal, and citation graph.

Toxicity of tungsten and molybdenum disulphide particles after acute and subacute exposure in vitro.

Toxicology and applied pharmacology·2026

State-of-the-Art Review on Finite Element Analysis Applied to Ultrathin-Strut Drug-Eluting Stents: Examining the Present and Looking Ahead to the Future.

Bioengineering (Basel, Switzerland)·2026

Are RNA Therapies a Solid Foundation or a Frontier Yet to Be Conquered?

International journal of molecular sciences·2026

Sedation early after return of spontaneous circulation and during pre-hospital transport after out-of-hospital cardiac arrest: retrospective analysis of the AfterROSC1 & 2 database.

Resuscitation·2026

Outcome After Surgery for Type A Intramural Hematoma.

Journal of cardiovascular development and disease·2026

The gut-bone axis: microbial metabolism and nutritional interventions for bone health.

Gut microbes·2026

See all related articles