Anaesthesia Cognition Evaluation (ACE) Study

据了解，在55岁以上的患者中，约有10%的患者在手术和麻醉后3个月出现认知和思维困难。澳大利亚每年进行200多万次涉及麻醉的手术，而且越来越多的患者是老年人，因此面临手术后认知能力下降的风险。我们有初步数据显示，手术前认知功能有轻微变化的人(称为轻度认知障碍)，在麻醉和手术后容易出现进一步的认知衰退。为了探索术前认知功能和术后认知功能下降之间的关系，我们计划测量择期髋关节置换手术患者的认知功能。这是通过让患者完成一系列标准的认知测试来实现的。然后，我们将能够在手术前识别那些已经有轻度认知障碍的患者，并在手术后通过反复测试将能够证明术前认知状态是否是术后认知功能障碍的决定因素。这项研究的主要目的是测试65岁以上接受全髋关节置换手术的患者手术前的认知障碍是否会导致手术后的认知障碍。这项研究还将确定这组患者术前轻度认知障碍的患病率和术后认知功能障碍的程度。本研究将探讨术前认知状态与术后认知缺陷的关系，为术后认知缺陷的发生率、自然病史及危险因素提供信息。这项工作将使进一步的研究能够分离特定的致病因素，并确定治疗和预防策略。

It is known that about 10% of patients over the age of 55 have difficulty with cognition and thinking 3 months after surgery and anaesthesia. Over 2 million operations involving anaesthesia are administered in Australia every year and increasingly the patients are elderly and thus exposed to the risk of cognitive decline after surgery. We have preliminary data showing that people who have mild changes in cognitive function before the surgery (known as mild cognitive impairment) are susceptible to further cognitive decline after anaesthesia and surgery. In order to explore the relationship between preoperative cognitive function and postoperative cognitive decline we plan to measure cognition in patients scheduled for elective hip replacement surgery. This is done by asking patients to complete a standard battery of cognitive tests. We will be then able to identify those patients who already have mild cognitive impairment before surgery and by repeated testing after the operation will be able to demonstrate if preoperative cognitive status is a determinant of postoperative cognitive dysfunction. The primary aim of the research is to test whether cognitive impairment before surgery leads to cognitive deficit after surgery in patients over the age of 65 undergoing total hip replacement surgery. The study will also establish the prevalence of pre-operative mild cognitive impairment and the magnitude of postoperative cognitive dysfunction after surgery in this patient group. The study will explore the relationship between preoperative cognitive status and postoperative cognitive deficit , providing information about the incidence, natural history and risk factors of postoperative cognitive deficit. This work will enable further research to isolate specific causative factors and identify therapeutic and prophylactic strategies.