About this trial
Anesthesia is a drug induced, reversible, comatose state that facilitates surgery and it is widely assumed that cognition returns to baseline after anesthetics have been eliminated. However, many patients have persistent memory impairment for weeks to months after surgery. Cardiac surgery appears to carry the highest risk of postoperative cognitive dysfunction (POCD). These cognitive deficits are associated with increased mortality, prolonged hospital stay and loss of independence. The investigators propose to investigate the role of Dexmedetomidine (DEX) in preventing long-term POCD after cardiac surgery and enhancing early postoperative recovery. It is anticipated that DEX will be the first effective preventative therapy for POCD, improve patient outcomes, and reduce length of stay and healthcare costs.
Eligibility criteria
Qualifiers
Planned CABG (+/- valve, including off-pump) or valve replacement via sternotomy/thoracotomy, with initial recovery in the Cardiovascular Intensive Care Unit (CVICU)
Age ≥60
Disqualifiers
Lack of patient consent
Pre-operative major cognitive dysfunction (CogState Brief Battery score < 80) at screening
Aortic arch replacement/re-implantation (surgery requiring hypothermic circulatory arrest, e.g. Bentall procedure)
Allergy/contraindication to dexmedetomidine (untreated 2nd degree type 2 or 3rd degree heart block (pacemaker), cirrhosis, HR < 50 , grade 4 LV, renal failure or on renal replacement therapy)
Trial design
Treatments tested in this trial
- Dexmedetomidine Hydrochloride Group
Treatment groups
Sponsors and collaborators
Sunnybrook Health Sciences Centre
Lead sponsor
London Health Sciences Centre
Collaborator
University Health Network, Toronto
Collaborator
McMaster University
Collaborator
Canadian Institutes of Health Research (CIHR)
Collaborator
The Dana Foundation
Collaborator
Brain Canada
Collaborator
Alzheimer's Association
Collaborator
Hamilton Health Sciences Corporation
Collaborator
University of Saskatchewan
Collaborator
Fraser Health
Collaborator
Providence Health & Services
Collaborator