None listed
Conditions
Brief summary
Recently, novel anesthesia techniques have developed and low-flow anesthesia method has become to gain more interest worldwide. In contrast to normal flow anesthesia where the flow of gas to the breathing system is between 2 L min-1, low flow anesthesia where the flow of gas is less than or equal to 1 L min-1 aims to give at least 50% of oxygen to the patient with sufficient proportion of volatile anesthetic agent to meet the need of the body after CO2 is separated from the gas expired from the patient. The most important advantages of this novel anesthesia technique are reduced cost because of decreased volatile anesthetic gas consumption and less air pollution. Desflurane is one of the most used volatile anesthetic agents in clinical practice. Because desflurane is less soluble in blood and tissues, has a wide range for performing doses and is titrated easily and rapidly, it can be used as optimal volatile anesthetic agent for low flow anesthesia. Myocardial repolarization can be evaluated by QT interval and T peak to T end interval on surface ECG. Studies showed that increased QT and T peak to T end interval was associated with poor prognosis in cardiovascular diseases. We hypothesized that low flow desflurane anesthesia may has lower cardiac adverse effect than normal flow desflurane anesthesia. Although it is known that normal flow desflurane anesthesia increases the duration of myocardial repolarization, the effect of low flow desflurane anesthesia on myocardial repolarization is not clear. In this study, we aimed to investigate the effect of low flow and normal flow desflurane anesthesia on QT and T peak to T end interval.
Interventions
Patients undergoing rhinoplasty operation will be randomized to receive either low flow anesthesia or normal flow anesthesia groups. Randomisation will be performed with the closed envelope method. Drug interventions will be performed by anaesthetist. Anesthesia induction will be performed with propofol 2mg/kg and fentanyl 1µg/kg. Each group will be given desflurane (50% oxygen and 50% air mixture with 6% desflurane) as an inhaler anesthetic agent. Normal flow anesthesia will be defined as follo
Patients undergoing rhinoplasty operation will be randomized to receive either low flow anesthesia or normal flow anesthesia groups. Randomisation will be performed with the closed envelope method. Drug interventions will be performed by anaesthetist. Anesthesia induction will be performed with propofol 2mg/kg and fentanyl 1µg/kg. Each group will be given desflurane (50% oxygen and 50% air mixture with 6% desflurane) as an inhaler anesthetic agent. Normal flow anesthesia will be defined as follows: the fresh gas flow was administered at 4-6 L/min for the first 6-8 minutes. After seeing minimum alveolar concentration achieved to +1 on anesthesia device, fresh gas flow rate will be reduced to 2 L/min (fresh gas flow rate: 2 L/min). Low flow anesthesia will be defined as follows: the fresh gas flow was administered at 4-6 L/min for the first 6-8 minutes. After seeing minimum alveolar concentration achieved to +1 on anesthesia device, fresh gas flow rate was reduced to 0.5 L/min (fresh gas flow rate: 0.5 L/min). Desflurane volume will be adjusted according to the MAC 1 in both groups during anesthesia maintenance. The fidelity of of intervention will be assessed by device analytics. 12-lead electrocardiography (ECG) will be taken from all patients during the operation by anaesthetist. In addition, oxygen saturation, heart rate, noninvasive systolic-diastolic blood pressure, total desflurane intake and total consumption, carbon dioxide inspiratory and expiratory concentration, inspiratory and expiratory oxygen values, and oxygen uptake will be monitored during the operation. Hemodynamic data and gas concentration values will be recorded on the monitor preoperatively, after induction, immediately after intubation, at 1, 5, 10 minutes after intubation, and every 5 minutes thereafter and after extubation.
Sponsors
Sanliurfa Mehmet Akif Inan Training and Research Hospital
Study design
Allocation
Randomised controlled trial
Intervention model
Parallel
Primary purpose
Treatment
Masking
Open (masking not used)
Eligibility
Sex/Gender
All
Age
18 Years to 65 Years
Healthy volunteers
No
Inclusion criteria
Patients undergoing rhinoplasty operation and aging between 18-65 years, with American Society of Anaesthesiologist (ASA) grades I or II will be included in this randomized study.
Exclusion criteria
ASA grades III or higher; previous history of hepatic, renal or cardiovascular diseases; known allergy to any of the used medications; pregnant patients; patients with electrolyte imbalance;, those using drugs that may affect myocardial repolarization (antiarrhythmic, beta-blocker, positive inotropic agent, tricyclic antidepressant, phenotiazine); bundle branch block on ECG; diabetes mellitus or other endocrine disorder; patients who develop laryngospasm during induction
Outcome results
None listed