Desflurane Potentially Induces Postoperative Cognitive Dysfunction in Elderly Patients Undergoing Perioperative Procedures by Modulating Cdc42 and Clock Proteins

Inclusion Criteria: * Age \> 70 years * American Society of Anesthesiologists (ASA) physical status classification I-III * Scheduled to undergo elective surgery requiring general anesthesia with desflurane * Able and willing to provide voluntary written informed consent * Able to understand the study procedures and complete follow-up assessments Exclusion Criteria: * Pre-existing diagnosis of dementia or any other neurodegenerative disease that could affect cognitive function * Preoperative Montreal Cognitive Assessment (MoCA) score \< 20 * History of severe psychiatric disorders, including psychosis, severe depression, or bipolar disorder * Unstable angina, uncontrolled hypertension, or a history of myocardial infarction within the past 6 months * Severe chronic obstructive pulmonary disease (COPD) with significant respiratory compromise, or other significant respiratory disease * Severe hepatic or renal impairment, defined as Child-Pugh class C for liver disease, or glomerular filtration rate (GFR) \< 30 mL/min/1.73 m2 for kidney disease * History of stroke, transient ischemic attack (TIA), or other significant neurological disorders * History of alcohol or drug abuse * Patients with visual, auditory, or language impairments that would interfere with cognitive testing. * Known allergy or contraindication to any of the study drugs * Other conditions at the discretion of the investigator that could interfere with the conduct of the study or the interpretation of the result…