Evaluating Enhanced Anesthesia Techniques for Elderly Patients Undergoing Hip Fracture Surgery to Improve Brain Function After Surgery

What this Trial Is About

Researchers are evaluating different enhanced anesthesia techniques to understand their effects on brain function after surgery in elderly patients undergoing hip fracture repair. This trial aims to compare these new anesthesia methods with the standard care to see if they influence the rate of neurocognitive disorders during the first week after surgery. The study is designed as a multi-arm, adaptive, open-label, randomized controlled platform trial involving multiple centers and elderly patients aged 65 and older. Participants will be randomly assigned to one of three groups standard anesthesia care, standard anesthesia combined with a nerve block, or standard anesthesia combined with intravenous lidocaine infusion. The nerve block is performed preferably with ultrasound guidance and involves long-acting local anesthetics, while the lidocaine infusion starts before surgery and continues until the patient leaves the post-anesthesia care unit. If any intervention shows effectiveness during interim analyses, it may be added to the standard care protocol. During the study, participants will be monitored for neurocognitive disorders and other complications up to one year after surgery. Assessments include the incidence and severity of delirium and cognitive decline, pain levels, hospital stay length, anxiety and depression scales, quality of life questionnaires, and mortality rates. The primary outcome is the rate of neurocognitive disorder events within the first seven days post-surgery. Follow-up will continue for up to one year to evaluate long-term cognitive outcomes and overall recovery.

Anesthesia and Perioperative Neurocognitive Disorders in the Elderly Patients Undergoing Hip Fracture Surgery Platform Trial (ANDES Platform Trial)