Thoracic Surgery
Conditions
Brief summary
Desflurane and its effect on postoperative morbidity and mortality in patients undergoing thoracic surgery. Halothane, enflurane, isoflurane, sevoflurane, and desflurane are volatile anesthetics, a group of general anesthetics. Because of the hypnotic effects of these agents, attention has mainly focused on the central nervous system. In the last 10 years, however, numerous studies have reported that volatile anesthetic agents interact with membrane structures of the myocardium and thereby attenuate cardiac mechanical dysfunction and limit ultrastructural abnormality on reperfusion after prolonged ischemia in the myocyte. Anesthetic-induced preconditioning has become a main topic in cardiac research worldwide * Trial with medicinal product
Interventions
DRUGDesflurane
4-6 Vol %
DRUGPropofol
TIVA to achieve BIS value of 40-60
Sponsors
Cantonal Hospital of St. Gallen
Kantonsspital Münsterlingen
University Hospital, Basel, Switzerland
Insel Gruppe AG, University Hospital Bern
University of Zurich
Study design
Allocation
RANDOMIZED
Intervention model
PARALLEL
Primary purpose
TREATMENT
Masking
NONE
Eligibility
Sex/Gender
ALL
Age
18 Years to 80 Years
Healthy volunteers
No
Inclusion criteria
• Elective thoracic surgery (thoracotomy, thoracoscopy) * Lung resection * One-lung ventilation * Adults (18-80 years of age) * ASA classification I - III * Written consent (signature from patient)
Exclusion criteria
* Known hypersensitivity or suspected allergy to propofol, soja or egg proteins * Known hypersensitivity to volatile anesthetics (malignant hyperthermia) * Medication with high dosage of statins * Therapy with cyclosporin * Severe renal impairment (GFR \< 30 ml/min) * Oral steroid treatment at present or stopped less than 3 months before surgery * Inflammatory processes (non-pulmonary or pulmonary): elevated C-reactive protein level (\> 20 mg/l) or leukocytosis (leukocytes \> 10x103/?l) or body temperature \> 37°C) * Pregnancy * Breast feeding * The subject must not be involved in any other clinical trial during the course of this trial, nor within a period of 30 days prior to its beginning or 30 days after its completion
Design outcomes
Primary
| Measure | Time frame |
|---|---|
| Major complications as defined as ≥ grade IIIa according to classification of surgical complications from Dindo et al. after lung resection with one-lung ventilation during hospitalization | postoperative phase until discharge; 6 month after surgery |
Secondary
| Measure | Time frame |
|---|---|
| Major complications ≥ grade IIIa according to classification of surgical complications from Dindo et al. after dimissio up to 6 months after surgery | postoperative phase until discharge, 6 month postoperative |
| Perioperative inflammatory mediators TNF-α, IL-6, IL-8, sICAM-1, MCP-1, MIP-2 in blood (correlation to complications ≥ grade IIIa according to classification of surgical complications from Dindo et al. during hospitalization) | postoperative phase until discharge |
Countries
Switzerland
Outcome results
None listed