spinal disease requiring laminectomy
Conditions
Interventions
Application of cerebral oximeter sensor on the forehead to monitor changes in cerebral oxygenation using remimazolam or propofol
Sponsors
Lazaro Castro Betina
Jin Zhuan
Ueda Kenichi
Eligibility
Inclusion criteria
Inclusion criteria: Eligibility Criteria for Elderly Participants (70 years or older): Diagnosis: Presence of spinal diseases requiring single or double-level laminectomy of the thoracic and/or lumbar spine. ASA Classification: Patients classified as ASA I-III (including relatively healthy patients and those with mild to moderate systemic diseases). BMI: BMI between 18.5 and less than 30. Position Tolerance: Ability to tolerate the prone position. Informed Consent: Ability to fully understand the research plan and provide informed consent independently. Operating Table: Spinal surgery using a surgical table such as Mizuno OSI Trios or Mizuno MOT-8300, with a pillow designed for the prone position.
Exclusion criteria
Exclusion criteria: 1. Uncontrolled cardiovascular diseases (e.g., heart failure, severe arrhythmias) 2. Severe respiratory diseases (e.g., chronic obstructive pulmonary disease, high-risk obstructive sleep apnea syndrome [vital capacity 1.5, or APTT >40 seconds) 6. Uncontrolled diabetes or other metabolic disorders affecting anesthetic response 7. History of allergies to remimazolam, propofol, benzodiazepines, or soy/egg-based products 8. Closed-angle glaucoma 9. Emergency surgery 10.Surgical procedures requiring complex operations other than laminectomy 11. Spinal surgery requiring head fixation with a 3-point fixation system 12. Anesthesia history within the past 30 days 13. Refusal to participate in the study
Design outcomes
Primary
| Measure | Time frame |
|---|---|
| mean rScO2 measured by NIRS at different time points throughout the procedure | — |
Secondary
| Measure | Time frame |
|---|---|
| Incidence of cerebral desaturation events Incidence of postoperative delirium Changes in hemodynamic parameters (MAP, HR, CO, PaO2, paCO2) over time Incidence of intraoperative complications (hypo/hypertension, brady/tachycardia, hypoxemia) Impact of prone positioning on cerebral oxygenation and hemodynamics (changes in rScO2, MAP, PaO2, PaCO2, and CO) before versus after prone positioning | — |
Contacts
Public ContactBetina Lazaro
Department of Anesthesiology
Outcome results
None listed