Effects of Ciprofol on Postoperative Delirium and Outcomes in Elderly Patients Undergoing Major Thoracic Surgery

Inclusion Criteria:

• Age ≥65 years old, gender unlimited;

• Selective thoracoscopic lobectomy and segmental lung resection were performed, andthe estimated time of anesthesia (from the beginning of anesthesia to the end ofsurgery) was ≥2 hours;

• ASA score is Grade I ~III; (Annex 1)

• A BMI of 18.5 to 29.9 kg/m2 [BMI= weight (Kg)/height (m) 2] (2013 U.S. Guidelinesfor the Management of Overweight and Obesity in Adults);

• Postoperative hospital stay more than 72 hours;

• Ethical, patients voluntarily take the test and sign the informed consent.

Exclusion Criteria:

• Emergency surgery; Hypovolemia, shock or coma;

• In addition to general intravenous anesthesia, other anesthesia methods should becombined, such as inhalation anesthesia, epidural anesthesia, peripheral nerveblock, etc., but it is not necessary to exclude patients with local infiltration oflocal anesthetic incision;

• Serious cardiovascular disease, including a history of myocardial infarction within 6 months, bradycardia (resting heart rate < 50 beats/min); Patients withhypertension whose blood pressure is not satisfactorily controlled (seated systolicblood pressure ≥160 mmHg during screening, and/or diastolic blood pressure ≥100 mmHgduring screening); Sitting systolic blood pressure ≤90 mmHg during the screeningperiod; A history of severe heart valve disease.

• Abnormal liver function, AST and/or ALT≥2.5×ULN, TBIL≥1.5×ULN;

• Abnormal renal function, urea or urea nitrogen ≥1.5×ULN, blood creatinine greaterthan the upper limit of normal;

• Glycated hemoglobin (HbA1c) ≥ 8.5%, fasting blood glucose ≥180 mg/dl (10 mmol/L),blood glucose ≥270mg/dl (15mmol/L) 1 hour after meals, or blood glucose ≥216 mg/dl (12mmol/L) 2 hours after meals;

• Patients with type I and type II expiratory failure

• Preoperative anemia (Hb≤90 g/L), thrombocytopenia (PLT≤80×109/L), hypoproteinemia (Alb≤30 g/L);

• A history of drug use and/or alcohol abuse within the 2 years prior to screening,with alcohol abuse being an average consumption of more than 2 units of alcohol perday (1 unit =360 mL beer or 150 mL of 45 mL liquor or wine with an alcoholconcentration of 40%);

• Patients with neurological diseases (stroke, Alzheimer's disease, Parkinson'sdisease, mental illness, myasthenia grave, etc., within 6 months), psychiatricdiseases (schizophrenia, mania, bipolar disorder, insanity, etc.), long-term historyof taking psychiatric drugs and cognitive impairment (using the simple mental StateAssessment Form (MMSE scale (Annex 2));

• Patients who take sedative sleeping drugs and antiepileptic drugs for a long time;

• Allergic to the investigational drug or contraindicated;

• Participated in other drug clinical trials as a subject within the last 3 months;

• Patients who refused or were unable to cooperate with the study;

• Other conditions that the investigator considers inappropriate to participate inthis study.