EEG DSA-guided Intravenous Anesthesia Using Dexmedetomidine and Propofol

Anesthetic Sparing Effects of Dexmedetomidine During Craniotomy: a Retrospective Propensity Score Matching Comparison Between Encephalographic Spectrogram-guided and Processes Encephalographic Index-guided Protocol

Status

UNKNOWN

Phases

Unknown

Study type

Observational

Source

ClinicalTrials.gov

Registry ID

NCT05656547

Enrollment

140

Registered

2022-12-19

Start date

2022-12-12

Completion date

2023-02-25

Last updated

2022-12-21

For informational purposes only — not medical advice. Sourced from public registries and may not reflect the latest updates. Terms

Conditions

Brain Surgery

Keywords

electroencephalogram, dexmedetomidine, total intravenous anesthesia, craniotomy

Brief summary

Investigators conduct this retrospective analysis to test this hypothesis that the EEG spectrogram guided general anesthesia with dexmedetomidine co-administration with propofol may significantly reduce the propofol consumption during craniotomy and to investigate potential benefits on postoperative outcomes.

Detailed description

The bispectral index (BIS), is widely applied to maintain anesthetic depth. However, this processed EEG index may be ambiguous when dexmedetomidine is administrated. Because each anesthetic produces distinct brain states that are readily visible in the EEG spectrogram which can be easily interpreted by anesthesiologists, the EEG spectrogram-guided anesthesia is theoretically beneficial to avoid unnecessary anesthetic exposure when dexmedetomidine is co-administrated but this remains not yet clarified. Recently, the investigators reported a randomized controlled trial which revealed that co-administration of dexmedetomidine with propofol by using the BIS score guidance, is associated with profound propofol sparing effects and more favorable postoperative neurological outcomes (Eur J Anaesthesiol . 2021 Dec 1;38(12):1262-1271.). Based on the advance of knowledge of EEG spectrogram, the investigators have transited our practice based on the EEG spectrogram guidance. In this study, the investigators analyze the influence of EEG spectrogram guidance on the propofol sparing effect and the postoperative profile in comparison to patients of our previous BIS-guided protocol.

Interventions

None listed

Study design

Observational model

CASE_CONTROL

Time perspective

RETROSPECTIVE

Eligibility

Sex/Gender

ALL

Age

20 Years to 80 Years

Healthy volunteers

Inclusion criteria

* Patients undergoing elective craniotomy for brain tumor resection, aneurysm clipping, an intracranial bypass procedure, or microvascular decompression * age between 20 to 80 yr

Exclusion criteria

* Fever, elevated white blood cell or C-reactive protein * Impaired liver function, eg. AST or ALT \>100; liver cirrhosis \> Child B class * Impaired renal function, cGFR\< 60 ml/min/1.73 m2 * Cardiac dysfunction, such as heart failure \> NYHA class II

Design outcomes

Primary

Measure	Time frame	Description
Propofol dose requirement	4-6 hours	Intraoperative propofol consumption

Secondary

Measure	Time frame	Description
Postoperative delirium	During hospital stay, estimated 7-10 days	Postoperative delirium diagnosed using the Intensive Care Delirium Screening Checklist (ICDSC) criteria
Postoperative Barthel index change	During hospital stay, estimated 7-10 days	Barthel index changes between the states of admission and discharge

Countries

Taiwan

Contacts

Primary ContactChun-Yu Wu

b001089018@tmu.edu.tw886-2-23562158

Outcome results