Stabilizing Hypnotic Depth and Vital Sign During Balanced Anesthesia
Conditions
Brief summary
Balanced anesthesia combining volatile anesthetics and opioids is commonly used in modern anesthesia. The purpose of this study is to compare two methods of administering desflurane, an volatile anesthetic during balanced anesthesia. The investigators hypothesized that administering desflurane at 1 MAC (minimum alveolar concentration) during balanced anesthesia will be more beneficial in terms of stability of the patient's vital signs and hypnotic depth than administering desflurane according to the patient's BIS (bispectral index) value.
Interventions
DRUGAdministering desflurane according to the patient's BIS value
Administering desflurane according to the patient's BIS value
DRUGAdministering desflurane at 1 MAC
Administering desflurane at 1 MAC
Sponsors
Seoul National University Hospital
Study design
Allocation
RANDOMIZED
Intervention model
PARALLEL
Primary purpose
SUPPORTIVE_CARE
Masking
TRIPLE (Subject, Investigator, Outcomes Assessor)
Eligibility
Sex/Gender
ALL
Age
20 Years to 90 Years
Healthy volunteers
No
Inclusion criteria
* Patients scheduled for operation under balanced anesthesia using desflurane and remifentanil
Exclusion criteria
* Refusal of consent * General anesthesia with agents other than desflurane and remifentanil * Patients with allergy to neuromuscular blocker, volatile anesthetics, opioids * History of malignant hyperthermia * Patients taking CNS stimulants * Chronic alcohol abuser * Patients with severe depressed left ventricular function, EF \< 30% * Patients with convulsive disorders * ASA class IV, V, VI * Patients with systolic arterial blood pressure lower than 90mmHg before surgery * Patients needing inotropic infusion during surgery * Anesthesia time less than 30 minutes
Design outcomes
Primary
| Measure | Time frame | Description |
|---|---|---|
| The difference of 'wobble' value of the patients' BIS value between the two groups | Every second from 10 minutes after skin incision to 10 minutes before surgery end. | 'Wobble' is a variable that can measure the performance measurement of a pharmacokinetic model, or the reaction of the patient to a drug. We can calculate the performance error from the target of the therapy and the actual measured value, and derive the wobble by a specific formulas, which are described below. PE=(BISmeasured-BIStargeted)x100/BIStargeted MDPEi = median{PEij, j=1,…,Ni} MDAPEi = median{\|PEij\|, j=1,…,Ni} Wobblei = median{\|PEij-MDPEi\|, j=1,…,Ni} Divergence = slope{\|PEij\|, j=1,…,Ni} |
Secondary
| Measure | Time frame | Description |
|---|---|---|
| The difference of 'wobble' value of the patients' systolic arterial blood pressure value between the two groups | Every 2.5 minutes from 10 minutes after skin incision to 10 minutes before surgery end | Described above |
Other
| Measure | Time frame |
|---|---|
| Eye opening time to prodding after stopping of anesthetics. | 1 min,2 min,3 min, 4min, 5min, 6min, 7min, 8min, 9min, 10min after stopping injection of anesthetics |
Countries
South Korea
Outcome results
None listed