General Anesthetic Drug Adverse Reaction
Conditions
Keywords
Desflurane, end tidal concentration, age, anesthesia
Brief summary
There is accumulating evidence that inappropriate depth of anaesthesia is associated with increased risk of postoperative complications including risk of death. The aim of this study was to identify factors determining the effective end-tidal concentration (EEtC) of desflurane, duration of wash in and wash out phase, and to estimate the risk of perioperative awareness in patients undergoing elective neurosurgical procedure.
Detailed description
All patients with American Society of Anesthesiologists (ASA) physical status I-III scheduled for elective neurosurgical procedure under general anaesthesia are studied. In each individual, the manufacturer recommended age-corrected end-tidal concentrations of desflurane is set and achieved initially. Individual effective end-tidal concentration (EEtC) of desflurane is then defined according to entropy parameters and maintained in the targeted range of static and response entropy 40-50. Effective analgesia is maintained according to surgical plethysmographic index (SPI) and dose of muscle relaxants according to neuromuscular transmission monitoring (TOF). Comorbidity, regular intake of alcohol and medication, smoking, sex, weight, height, and age are recorded. Postoperative questionnaire is used to reveal the intraoperative awareness.
Interventions
DRUGdesflurane - oxygen in air
The manufacturer recommended age-corrected end-tidal concentrations of desflurane in air should be set and achieved initially. Individual EEtC of desflurane will be defined according to entropy parameters and maintained in the targeted range of static and response entropy 40-50
DRUGdesflurane - oxygen in nitric oxide
The manufacturer recommended age-corrected end-tidal concentrations of desflurane with nitric oxide - oxygen should be set and achieved initially. Individual EEtC of desflurane will be defined according to entropy parameters and maintained in the targeted range of static and response entropy 40-50
Sponsors
University Hospital Hradec Kralove
Study design
Allocation
NON_RANDOMIZED
Intervention model
PARALLEL
Primary purpose
TREATMENT
Masking
SINGLE (Subject)
Eligibility
Sex/Gender
ALL
Age
18 Years to 78 Years
Healthy volunteers
No
Inclusion criteria
* ASA I-III * elective neurosurgical procedure under general anaesthesia * Age between 18 and 78 * elective procedures with estimated duration 1 - 3 hours
Exclusion criteria
* Glasgow coma scale GCS below 14 * other rhythm than sinus * pacemaker stimulation * planned postoperative ventilation
Design outcomes
Primary
| Measure | Time frame |
|---|---|
| end tidal concentration of desflurane according to age | from the start of procedure up to 4 hours |
Secondary
| Measure | Time frame | Description |
|---|---|---|
| Time to spontaneous ventilation | from end of anesthesia up to 1 hour | — |
| Time to extubation | from the end of anesthesia up to 1 hour | — |
| Time to reaction to command | from the end of anesthesia up to 1 hour | — |
| Wash in phase | up to achievement of manufacturer age-corrected end-tidal concentrations of desflurane up to 10 minutes | sec |
| Wash out phase | from the end of procedure up to 1 hour | — |
Countries
Czechia
Outcome results
None listed