Not Yet RecruitingPhase 4

Dexmedetomidine-esketamine and tDCS for Prevention of Neurocognitive Complications After Surgery

China1,160 participantsStarted 2026-06

Plain-language summary

Neurocognitive complications, mainly delirium and neurocognitive disorders, are common cerebral complications in older patients after surgery and associated with worse outcomes. In previous studies, perioperative use of dexmedetomidine-esketamine combination improved analgesia and sleep quality after surgery. Perioperative use of transcranial direct current stimulation (tDCS) also improved sleep quality and reduced delirium occurrence early after surgery. This 2×2 factorial trial is designed to investigate the effects of perioperative dexmedetomidine-esketamine combination and tDCS on early postoperative neurocognitive recovery and delirium occurrence in older patients.

Who can participate

Age range

65 Years – 90 Years

Sex

ALL

See this in plain English?

AI-rewrites the medical criteria so a patient or caregiver can understand them. Always confirm with the trial site.

Inclusion Criteria: * Aged 65 to 90 years; * Preoperative Mini-Mental State Examination (MMSE) score \< 27 points, indicating possible cognitive impairment ranging from mild to moderate; * Scheduled to undergo elective non-cardiac, non-neurosurgical surgery under general anesthesia, with an expected surgical duration \> 1 hour; * Required patient-controlled intravenous analgesia (PCIA) after surgery. Exclusion Criteria: * Preoperative inability to communicate due to coma, severe dementia, end-stage disease, or language impairment; * History of schizophrenia, epilepsy, Parkinson's disease, brain trauma/surgery, or myasthenia gravis; * Presence of metal implants in the intracranial or cervical region (such as cochlear implants, aneurysm clips, deep brain stimulation electrodes), or skin damage or severe skin disease on the head; * Severe cardiac dysfunction (left ventricular ejection fraction \< 30%), comorbid with sick sinus syndrome, severe bradycardia (heart rate \< 50 bpm), or second-degree or higher atrioventricular block, or implantation of a cardiac pacemaker; * Uncontrolled hyperthyroidism or pheochromocytoma; * Severe liver dysfunction (Child-Pugh class C), severe renal dysfunction (requiring dialysis), or ASA classification ≥ IV; * Allergy to dexmedetomidine or esketamine; * Participation in other clinical studies within the past 3 months; * Other conditions that are deemed unsuitable for study participation.

Questions worth asking your doctor

Bring these to your next appointment. They're a starting point for a shared conversation — not a sign you qualify or a recommendation to enrol.

1Based on my diagnosis and history, is this trial worth exploring for me — or is there a standard treatment we should try first?
2What does this trial's phase tell us about how much is already known about its safety and benefit?
3What would taking part actually involve for me — visits, tests, time, and travel?
4What are the known and possible risks or side effects I should weigh, and how would they be monitored?
5If this trial isn't the right fit, what other options or trials would you suggest I look into?

Generated to help you prepare — always confirm anything about your own eligibility and care with the study team and your doctor.

Questions for the trial coordinator

The trial coordinator is the person who runs the study day to day. These cover the practical side — logistics, costs, and what taking part would actually mean for your life. The study team confirms whether you meet the criteria; these are questions to ask, not a sign you qualify.

1What does taking part actually involve week to week — how many visits, where, and how long does each one take?
2What costs are covered by the study, and what might I have to pay for myself, including travel, parking, or time off work?
3What happens during screening, and what happens if the study team confirms I don't meet the criteria after those tests?
4Who pays for the scans, blood work, and other tests the trial requires — the study, my insurance, or me?
5How will being in the trial affect my regular care, and will my own doctor stay informed and involved?
6Can I leave the trial at any point if I change my mind, and what would happen to my care if I do?

A starting point for the conversation — always confirm anything about your own eligibility, costs, and care with the study team and your doctor.

What they're measuring

Incidence of delayed neurocognitive recovery (dNCR)

Timeframe: At 5 days after surgery or before hospital discharge

Trial details

NCT IDNCT07576517

SponsorPeking University First Hospital

Sponsor typeOTHER

Study typeINTERVENTIONAL

Primary completion2029-06

Contact for this trial

Dong-Xin Wang, MD, PHD

86 10 83572784 wangdongxin@hotmail.com

View on ClinicalTrials.gov More Older Patients trials