Cerebral Ischemia
Conditions
Keywords
propofol, desflurane, cerebrovascular circulation, sitting
Brief summary
The investigators hypothesized that both propofol and desflurane would decrease the regional oxygen saturation (rSO2) but propofol is likely to reduce rSO2 more than sevoflurane when patients are raised to the sitting position.
Detailed description
The investigators hypothesized that both propofol and desflurane would decrease the rSO2 but propofol is likely to reduce rSO2 more than sevoflurane when patients are raised to the sitting position. Therefore, the purpose of this study was to investigate the effect of desflurane and propofol on rSO2 values during the beach chair position for shoulder arthroscopy.
Interventions
DRUGpropofol
anaesthesia was induced with the effect-site concentration of propofol 5.0 μg ml-1 mainly.
DRUGDesflurane
anaesthesia was maintained by desflurane 4-7vol%
DRUGalfentanil
administration of alfentanil 10 μg kg-1 for anesthetic induction
DRUGRocuronium
administration of rocuronium 0.6 mg kg-1 for anesthetic induction
Sponsors
Gachon University Gil Medical Center
Study design
Allocation
RANDOMIZED
Intervention model
PARALLEL
Primary purpose
PREVENTION
Masking
SINGLE (Investigator)
Eligibility
Sex/Gender
ALL
Age
20 Years to 65 Years
Healthy volunteers
No
Inclusion criteria
* Forty patients, * ASA class I or II, * undergoing shoulder arthroscopy
Exclusion criteria
* Patients with history of cerebrovascular disease, coronary occlusive disease and/or obesity (body mass index \> 30) were excluded from this study.
Design outcomes
Primary
| Measure | Time frame | Description |
|---|---|---|
| Regional Cerebral Oxygen Satuation (rSO2) | 1, 3, 5, 7, and 9 min after the beach chair position | definitive values of regional cerebral oxygen saturation(rSO2,%) values are described as mean (SD) |
Participant flow
Recruitment details
March 2011-August 2011 in Gachon University Gil Medical Center, who underwent arthroscopic shoulder surgery
Pre-assignment details
no enrolled participants were excluded.
Participants by arm
| Arm | Count |
|---|---|
| Desflurane anaesthesia was induced with thiopental sodium 2 mg kg-1, alfentanil 10 μg kg-1 and rocuronium 0.6 mg kg-1. Anesthetic maintenance by desflurane | 20 |
| Propofol anaesthesia was induced with the effect-site concentration of propofol 5.0 μg ml-1, alfentanil 10 μg kg-1, and rocuronium 0.6 mg kg-1. A commercially available target controlled infusion (TCI) pump (Orchestra®, Fresenius Vial, France) was used and the pharmacokinetic set used to calculate target effect-site concentrations for propofol was Schnider and colleagues' model | 20 |
| Total | 40 |
Baseline characteristics
| Characteristic | Propofol | Total | Desflurane |
|---|---|---|---|
| Age, Categorical <=18 years | 0 Participants | 0 Participants | 0 Participants |
| Age, Categorical >=65 years | 0 Participants | 0 Participants | 0 Participants |
| Age, Categorical Between 18 and 65 years | 20 Participants | 40 Participants | 20 Participants |
| Age Continuous | 48 years STANDARD_DEVIATION 16 | 48 years STANDARD_DEVIATION 14 | 48 years STANDARD_DEVIATION 10 |
| Region of Enrollment Korea, Republic of | 20 participants | 40 participants | 20 participants |
| Sex: Female, Male Female | 6 Participants | 15 Participants | 9 Participants |
| Sex: Female, Male Male | 14 Participants | 25 Participants | 11 Participants |
Adverse events
| Event type | EG000 affected / at risk | EG001 affected / at risk |
|---|---|---|
| deaths Total, all-cause mortality | — / — | — / — |
| other Total, other adverse events | 0 / 20 | 0 / 20 |
| serious Total, serious adverse events | 0 / 20 | 0 / 20 |
Outcome results
Primary
Regional Cerebral Oxygen Satuation (rSO2)
definitive values of regional cerebral oxygen saturation(rSO2,%) values are described as mean (SD)
Time frame: 1, 3, 5, 7, and 9 min after the beach chair position
Population: A power analysis was calculated based on a previous study.14 In each group, 16 patients were needed to detect a mean intergroup difference of 5% in the rSO2 value with a power of 80% and a type I error of 0.05. To compensate for a dropout rate of 20%, 40 patients were included in this study.
| Arm | Measure | Group | Value (MEAN) | Dispersion |
|---|---|---|---|---|
| Desflurane | Regional Cerebral Oxygen Satuation (rSO2) | 3min after beach chair position | 76 percentage of rSO2 (%) | Standard Deviation 7.1 |
| Desflurane | Regional Cerebral Oxygen Satuation (rSO2) | 7min after beach chair position | 75.1 percentage of rSO2 (%) | Standard Deviation 7.2 |
| Desflurane | Regional Cerebral Oxygen Satuation (rSO2) | 5min after beach chair position | 75.2 percentage of rSO2 (%) | Standard Deviation 7.4 |
| Desflurane | Regional Cerebral Oxygen Satuation (rSO2) | 9min after beach chair position | 74 percentage of rSO2 (%) | Standard Deviation 7.8 |
| Desflurane | Regional Cerebral Oxygen Satuation (rSO2) | 1min after beach chair position | 77.4 percentage of rSO2 (%) | Standard Deviation 7 |
| Propofol | Regional Cerebral Oxygen Satuation (rSO2) | 9min after beach chair position | 67.8 percentage of rSO2 (%) | Standard Deviation 9.8 |
| Propofol | Regional Cerebral Oxygen Satuation (rSO2) | 1min after beach chair position | 72.5 percentage of rSO2 (%) | Standard Deviation 9.5 |
| Propofol | Regional Cerebral Oxygen Satuation (rSO2) | 3min after beach chair position | 70 percentage of rSO2 (%) | Standard Deviation 9.8 |
| Propofol | Regional Cerebral Oxygen Satuation (rSO2) | 5min after beach chair position | 70 percentage of rSO2 (%) | Standard Deviation 8.5 |
| Propofol | Regional Cerebral Oxygen Satuation (rSO2) | 7min after beach chair position | 68.5 percentage of rSO2 (%) | Standard Deviation 10.1 |