Obesity
Conditions
Keywords
Bariatric surgery, Anesthesia
Brief summary
Obesity is increasing in France, resulting in an increased demand for bariatric surgery. However obesity also alters physiopathological pathways and the pharmacokinetics of anesthestic agents. The investigators objective is to compare, among morbidly obese patients, the immediate and intermediary emergence kinetics after balanced anesthesia using remifentanil associated either with desflurane (reference arm) or with xenon (experimental arm).
Interventions
DRUGDesflurane
Patients undergo anesthesia using remifentanil associated with desflurane
DRUGXenon
Patients undergo anesthesia using remifentanil associated with xenon
Sponsors
Centre Hospitalier Universitaire de Nīmes
Study design
Allocation
RANDOMIZED
Intervention model
PARALLEL
Primary purpose
TREATMENT
Masking
DOUBLE (Subject, Outcomes Assessor)
Eligibility
Sex/Gender
ALL
Age
18 Years to 65 Years
Healthy volunteers
No
Inclusion criteria
* American Society of Anesthesiologists (ASA) I to III * requires bariatric surgery * body mass index (BMI) \>= 35 kg/m2 * patient speaks and writes French * patient has signed consent form * patient enrolled in a social security program
Exclusion criteria
* patient refuses to sign consent * ASA IV or more * patient is pregnant or breastfeeding * history of hyperthermy (or suspicion, or family history thereof) * history of liver disease, icterus, unexplained fever, or eosinophilia after administration of a halogen anesthesia * patient has symptomatic gastro-oesophagean reflux * patient has hypersensitivity to one or more of the following substances: propofol, remifentanil, celocurine, cisatracurium, rocuronium, desflurane, xenon, paracetamol, ketoprofen, nefopam, tramadol * patient has obstructive respiratory failure (chronic obstruction pneumopathy, asthma) or has heart disease with severly altered cardiac function * patient has high intracranial pressure * patient requires high concentrations of oxygen (fio2\>40%) * patient has a neuro-sensorial deficient which prevents reading, writing, or response to simple oral commands (severe deafness, language impairment...)in the absence of a prothesis * patient has a psychiatric pathology, or chronically consumes alcohol or other mind-altering substance * patient has had general anesthesia in the last 15 days * patient under guardianship * impossible to correctly communicate information to the patient * absence of efficient contraception for women of childbearing age * participation in another study within the last 3 months
Design outcomes
Primary
| Measure | Time frame | Description |
|---|---|---|
| 30 min DSST ratio | 30 minutes post-op | (the number of correct responses to a Digit Symbol Substitution Test \[DSST\] 30 minutes after surgery) / (the number of correct responses to a Digit Symbol Substitution Test the night before the surgery) |
Secondary
| Measure | Time frame | Description |
|---|---|---|
| 60 min DSST test | 60 minutes post-op | (the number of correct responses to a Digit Symbol Substitution Test 60 minutes after surgery) / (the number of correct responses to a Digit Symbol Substitution Test the night before the surgery) |
| 90 min DSST test | 90 min post-op | (the number of correct responses to a Digit Symbol Substitution Test 90 minutes after surgery) / (the number of correct responses to a Digit Symbol Substitution Test the night before the surgery) |
| Time to Aldrete score of 10 | Immediate post-op; this outcome measures the minutes of emergence (from anesthesia) time necessary to attain an Aldrete score of 10 | Aldrete JA. The post-anesthesia recovery score revisited. J. Clin. Anesth. 1995. |
| Quality of recovery score | Day 1 post-op | The score on the Quality of Recovery Scale: Myles PS, Weitkamp B, Jones K et al. Validity and reliability of a postoperative quality of recovery score: the QoR-40. Br. J. Anaesth., 2000; 84: 11-15. |
Countries
France
Outcome results
None listed