General Anesthesia, Inhalation; Gas
Conditions
Keywords
Minumum alveoler concentration, Entropy monitorining, General anesthesia, General anesthesia combined with TEA
Brief summary
The aim of this study is to adjust the end tidal inhalation anesthetic concentration by observing the entropy value in patients who will be provided anesthesia maintenance with volatile anesthetics after applying the routine epidural anesthesia technique and to observe the end tidal volatile concentration that will provide to remain in the target entropy limits during the operation.
Detailed description
The hypothesis of this study is that in general anesthesia cases which is combined with thoracic epidural anesthesia (TEA), lower alveolar concentration will be required to reach the same anesthesia depth. The main aim of the study is observing and comparing the alveolar concentrations of anesthetic agents with entropy monitoring which is an anesthesia depth monitor in major abdominal surgeries where general anesthesia is combined or not with TEA. In cases where TEA is combined with general anesthesia or not, anesthesia depth will be effectively monitored by entropy monitoring, in this way the adequate depth of anesthesia will be provided with the use of minimal volatile anesthetics and we will be able to prevent the use of large amounts of volatile anesthetics., It will be determined how much reduction in alveolar concentration is required in cases combined with TEA. Nowadays, with the development of reliable anesthesia machines, low-flow anesthesia (LFA) is becoming more widespread, and its benefits on patient health, economy and ecology have been demonstrated. In LFA, the depth of anesthesia should not be too superficial or too deep during the time the alveolar concentration of volatile agent reaches equilibrium. Therefore, alveolar concentrations of volatile anesthetics are monitored in modern anesthesia machines. Some machines may also adjust the depth of anesthesia according to the alveolar concentration of the agent.
Interventions
DRUGBupivacaine
%0.25 bupivacaine solution
DRUGSevoflurane
End tidal sevoflurane concentration
Sponsors
Istanbul University
Study design
Allocation
NON_RANDOMIZED
Intervention model
PARALLEL
Primary purpose
SCREENING
Masking
DOUBLE (Subject, Outcomes Assessor)
Eligibility
Sex/Gender
ALL
Age
18 Years to 65 Years
Healthy volunteers
No
Inclusion criteria
* undergoing major abdominal surgery * Patients who will not undergoing operation for thoracic cavity * Body Mass Index (BMI) between 20-30
Exclusion criteria
* denial of patients * contraindications for thoracic epidural anesthesia * patients who are FEV1/FVC \< 60 * patients with thoracic and lomber vertebrae surgery
Design outcomes
Primary
| Measure | Time frame | Description |
|---|---|---|
| End tidal volatile anesthetic concentration | up to 20 minutes | End tidal volatile anesthetic concentration that keeps entropy in normal limits |
Secondary
| Measure | Time frame | Description |
|---|---|---|
| Total volatile anesthetic consumption | up to 2 hours | Amount of total inhalation anesthetic consumed during surgery |
| Time to reach target concentration | up to 10 minutes | Time to reach the end tidal anesthetic concentration that we set |
| Inhalation anesthetic amount the target concentration reached ( in the period of reaching the set alveolar concentration) | up to 5 minutes | The amount of inhalation anesthetic consumed until reaching the target concentration |
| The amount of propofol | 2 minutes | The amount of using propofol for anesthesia induction |
Other
| Measure | Time frame | Description |
|---|---|---|
| Total remifentanil consumption | up to end of the operation | Total remifentanil consumption when pain index (SPI) is above normal |
Countries
Turkey (Türkiye)
Outcome results
None listed