Anesthetics, Emergence Agitation, Rhinoplasty
Conditions
Keywords
Emergence Agitation, Anesthetics
Brief summary
Emergence agitation, defined as restlessness, disorientation, arousal, and/or inconsolable crying, is a common phenomenon seen in the early phase of recovery from general anesthesia; this may cause respiratory depression, nausea and vomiting, as well as an increase in blood pressure, heart rate and myocardial oxygen consumption. Although its pathogenesis remains unclear, ENT (ear, nose and throat) surgical procedures have been reported to have a higher incidence of agitation in both adults and children. In recent years, low-flow inhalation anesthesia has been widely used in adult anesthesia practice. The aim of this study is to compare the effects of low flow anesthesia and normal flow anesthesia on emergence agitation.
Detailed description
Emergence agitation, defined as restlessness, disorientation, arousal, and/or inconsolable crying, is a common phenomenon seen in the early phase of recovery from general anesthesia; this may cause respiratory depression, nausea and vomiting, as well as an increase in blood pressure, heart rate and myocardial oxygen consumption. Hypoxia can lead to serious complications such as aspiration pneumonia, bleeding or reoperation. Although its pathogenesis remains unclear, ENT (ear, nose and throat) surgical procedures have been reported to have a higher incidence of agitation in both adults and children. In recent years, low-flow inhalation anesthesia has been widely used in adult anesthesia practice. Low flow anesthesia has many advantages; the consumption of inhalation agents is reduced, the temperature and humidity of the airways are maintained, the cost of anesthesia and pollution caused by atmospheric waste gases are reduced. In addition, because the temperature and humidity of the tracheobronchial tree are preserved, respiratory functions and mucociliary activities are better preserved. In low-flow anesthesia, the concentration of inhaled anesthetics changes very slowly, and their concentration gradually decreases after the administration is terminated. Since the anesthetic concentration will slowly decrease in the low-flow group during termination of anesthesia, the concentration difference between the brain and lungs will be small. In addition, it is known that a longer period between discontinuation of the administration of anesthetic agents and extubation reduces emergence agitation. This seems possible with the low-flow anesthesia technique. The aim of this study is to compare the effects of low flow anesthesia and normal flow anesthesia on emergence agitation.
Interventions
OTHER: Conventional flow Anesthesia
During the initial wash-in period 2 L/min Fresh gas flow will be used.
OTHERLow Flow Anesthesia
Fresh gas flow rate will be 0.5 L/min throughout the procedure.
Sponsors
Inonu University
Study design
Allocation
RANDOMIZED
Intervention model
PARALLEL
Primary purpose
SCREENING
Masking
DOUBLE (Subject, Outcomes Assessor)
Eligibility
Sex/Gender
ALL
Age
18 Years to 50 Years
Healthy volunteers
Yes
Inclusion criteria
* 18-50 years * ASA class I-II, * scheduled for elective rhinoplasty surgery under general anesthesia
Exclusion criteria
* history of allergy to nonsteroidal anti-inflammatory drugs, * bleeding diathesis or anticoagulant use, * psychiatric drug use, * previous rhinoplasty surgery * patient refusal
Design outcomes
Primary
| Measure | Time frame | Description |
|---|---|---|
| Richmond Agitation-Sedation Scale (RASS) | From extubation to 30 minutes of arrival in the postoperative care unit | Sedation and agitation will be assessed immediately after extubation with the Richmond Agitation-Sedation Scale. RASS is divided into 10 levels (score range, -5 to 4, higher scores indicate more agitation) |
Secondary
| Measure | Time frame | Description |
|---|---|---|
| Ramsey Sedation Scale (RSS) | From extubation to 30 minutes of arrival in the postoperative care unit | RSS is divided into 6 levels (score range, 1-6, lower scores indicate more agitation). |
| Boezaart score | immediate postoperative period | the quality of the operating field in terms of bleeding (Boezaart score),Participating surgeons will rate surgical site visibility from 0 to 5 on the Boezaart rating scale, where 0 is the best and 5 is the worst. |
| Surgeon satisfaction | immediate postoperative period | . Surgeon satisfaction with the operative field will be rated at the end of surgery using a 5-choice Likert scale: 1 = very bad, 2 = bad, 3 = fair, 4 = good, and 5 = excellent. |
Countries
Turkey (Türkiye)
Outcome results
None listed