Ciprofol, Propofol and Sevoflurane for Postoperative Delirium in Elderly Brain Tumor Patients

Who can take part

• Aged 65 to 90 years, either sex
• Scheduled to undergo elective brain tumor resection under general anesthesia
• American Society of Anesthesiologists (ASA) physical status I-III
• Expected operative time ≥ 2 hours and anticipated postoperative hospital stay > 48 hours
• Able to communicate in Chinese and complete cognitive assessments
• Preoperative cognitive function intact: Telephone Montreal Cognitive Assessment (T-MoCA) score ≥ 18 and Confusion Assessment Method (CAM) negative
• No use of analgesic or sedative medications on the day before surgery
• Able to provide informed consent and willing to comply with postoperative follow-up through 180 days

Who cannot take part

• Preoperative use of medications that may affect postoperative cognition (e.g., long-term benzodiazepines, antidepressants, antipsychotics, or chronic sedative-hypnotic use that cannot be paused)
• Concurrent participation in another clinical trial
• Preoperative delirium, dementia, diagnosed severe psychiatric disorder, or existing central nervous system disease
• History of alcohol addiction or drug abuse; suspected or confirmed long-term use of narcotic analgesics or sedatives
• Severe visual, auditory, or speech impairment that precludes communication and cognitive testing
• Known difficult airway, malignant hyperthermia susceptibility, or other contraindication to general anesthesia
• Hypersensitivity or known allergy to ciprofol, propofol, sevoflurane, or other study-related agents
• Severe uncontrolled infection or endocrine disorder
• Severe cardiopulmonary disease: forced expiratory volume in 1 second (FEV1) or vital capacity < 50% of predicted; New York Heart Association (NYHA) functional class III-IV; severe hepatic or renal insufficiency (creatinine > 176 μmol/L, blood urea nitrogen > 7.1 mmol/L, albumin < 30 g/L, Child-Pugh class C, or preoperative dialysis)
• Judged unsuitable for enrollment by the attending surgeon, anesthesiologist, or principal investigator for any other reason