Laparoscopic Sleeve Gastrectomy
Conditions
Keywords
Total Intravenous Anesthesia, Inhalation Anesthesia, Laparoscopic Sleeve Gastrectomy
Brief summary
The pandemic of obesity has become a serious issue of public health worldwide as the size of the obese population has almost tripled over the last four decades and continues to riseزThe epidemic of obesity has led to a significant increase in the prevalence of non-alcoholic fatty liver disease (NAFLD). NAFLD is currently the most common chronic liver disease, with an estimated global prevalence at 25-30%, rising up to 90% in morbidly obese patients
Detailed description
Anesthesia and surgery may deteriorate liver function in patients with elevated liver enzyme levels; therefore, in these patients, choosing anaesthetics with less hepatotoxicity may be important. Halothane, which is a typical inhalational anesthetic, is known for its liver and kidney toxicity. The latest anesthetic agents, including sevoflurane and desflurane, are associated with less hepatotoxicity, although rare cases of acute liver injury have been reported with these agentsزPropofol (2,6-diisopropylphenol) is an intravenous anesthetic. Its pharmacokinetic profile makes it very suitable for total intravenous anesthesia (TIVA) and this is a widely used technique in many centers. Its use results in a rapid onset and offset with fewer side effects including postoperative nausea and vomiting, making it particularly favorable in the ambulatory setting
Interventions
For patients in the SEVO group, general anesthesia was induced with propofol 2 mg/kg, fentanyl 1 ug/kg and then maintained with sevoflurane in air and oxygen, dexmedetomidine 1 ug/kg/hour.
Patients in the TIVA group had anesthesia induced with propofol 2 mg/kg , fentanyl 1 ug/kg and maintained with propofol. 200 ug/kg/min, fentanyl 0.1ug/kg/min, dexmedetomidine 1 ug/kg/hour
Sponsors
Benha University
Study design
Allocation
RANDOMIZED
Intervention model
PARALLEL
Primary purpose
PREVENTION
Masking
NONE
Intervention model description
The participants were randomized into two equal groups using a computer-generated list of random numbers sealed in an opaque envelope and were randomly allocated into two groups on a scale of 1:1.
Eligibility
Sex/Gender
ALL
Age
20 Years to 70 Years
Healthy volunteers
No
Inclusion criteria
* Obese patients * had ASA I-III * diagnosed with non-alcoholic steatohepatitis (NASH) liver disease * undergoing laparoscopic sleeve gastrectomy
Exclusion criteria
* cases wherein surgeries were performed using anesthetic methods that were not clearly identified as TIVA or INHA * heart surgery or cesarean section, and cases of neuromuscular diseases
Design outcomes
Primary
| Measure | Time frame | Description |
|---|---|---|
| visual analogue scale | visual analogue scale was measured at day one and day two postoperatively | Pain was assessed by using the visual analogue scale (VAS) score for pain (0-no pain, 10-worst imaginable pain) |
Secondary
| Measure | Time frame | Description |
|---|---|---|
| Patient satisfaction | 24 hours postoperatively | 5-point Likert scale, (1=extremely dissatisfied; 5=extremely satisfied) |
Countries
Egypt
Outcome results
None listed