Effects of Intraoperative Targeted Temperature Management on Incidence of Postoperative Delirium and Long-term Survival in Older Patients Having Major Cancer Surgery: A Multicenter Randomized Trial

What this Trial Is About

Older patients undergoing major cancer surgery often experience intraoperative hypothermia, which can increase the risk of postoperative delirium—a condition marked by sudden changes in attention and cognition—and may also affect long-term outcomes like cancer recurrence and survival. This study evaluates whether managing body temperature more precisely during surgery can reduce postoperative delirium and improve progression-free survival. The trial focuses on patients aged 65 and older undergoing potentially curative cancer surgeries lasting two hours or more under general anesthesia. Participants are randomly assigned to one of two temperature management approaches. The routine thermal management group will not receive pre-warming; ambient temperature is kept near 20°C, and warming devices activate only if core temperature drops below 35.5°C. The target temperature for this group is 35.5°C. The target temperature management group receives pre-warming with a full-body forced-air cover and heated blanket before anesthesia, with continuous warming during surgery to maintain a core temperature near 36.8°C. Intravenous fluids are also warmed in this group. Throughout the study, researchers will monitor delirium incidence within the first four days after surgery and track progression-free survival for up to three years. They will also assess patients’ thermal comfort, shivering intensity, emergence delirium, blood transfusion needs, and neurocognitive disorders at six months post-surgery. This comprehensive monitoring includes temperature measurements and clinical evaluations to understand the effects of temperature management on short- and long-term recovery and survival.

Effects of Intraoperative Targeted Temperature Management on Incidence of Postoperative Delirium and Long-term Survival