High Spinal Anesthesia and the Incidence of Delirium After Cardiac Surgery
Post-Operative Confusion
About this trial
This is an interventional other trial for Post-Operative Confusion focused on measuring Cardiac surgery, Delirium, Spinal anesthesia
Eligibility Criteria
Inclusion Criteria:
- Adult (>18 years old) patients
- Undergoing elective or urgent cardiac surgical procedures with cardiopulmonary bypass
Exclusion Criteria:
- Contraindications to spinal anesthesia such as active anticoagulation, clopidogrel within 7 days of surgery, ticagrelor within 3 days of surgery and all other contraindications to lumbar puncture
- Pre-existing psychiatric diagnoses such as schizophrenia or manic-depressive disorder
- Complex aortic surgery (> hemi-arch repair, descending thoracic surgery)
- Difficult airway requiring an awake intubation
- BMI > 50
Sites / Locations
- St. Boniface HospitalRecruiting
Arms of the Study
Arm 1
Arm 2
Active Comparator
No Intervention
High spinal anesthesia
Control group
Spinal group: will receive high spinal anesthesia with hyperbaric bupivacaine (0.3 to 0.6 mgs/kg) + preservative free morphine (3 mcg/kg). Standard intraoperative monitors will include ECG, pulse oximetry, end-tidal CO2 and anesthetic gas measurement, quantitative EEG monitoring (BIS monitor), arterial line, central venous pressure line and any other monitor as clinically indicated. Conduct of the general anesthetic will not be protocolized. It will be a pragmatic study. The attending anesthesiologist will attempt to have a BIS score of 20- 40 during the operation.
Standard intraoperative monitors will include ECG, pulse oximetry, end-tidal CO2 and anesthetic gas measurement, quantitative EEG monitoring (BIS monitor), arterial line, central venous pressure line and any other monitor as clinically indicated. Conduct of the general anesthetic will not be protocolized. It will be a pragmatic study. The attending anesthesiologist will attempt to have a BIS score of 20- 40 during the operation.