Intraoperative Bleeding
Conditions
Brief summary
Nasal surgeries are common day case procedures. Although surgical complications are rare, bleeding decreases surgical field visibility and may cause vascular, orbital or intracranial complications in addition to failure of procedure. So, it is crucial to maintain hypotensive anaesthesia to optimize the surgical field.
Detailed description
In this study the investigators compare the effect of; propofol- lidocaine-magnesium and ketamine- lidocaine- magnesium infusions to dexmedetomidine- lidocaine- magnesium infusion on surgical field quality, intraoperative haemodynamics, surgical time, recovery time, sedation score, time to first rescue analgesic and incidence of PONV in patients undergoing nasal surgeries
Interventions
DRUGIntravenous Infusion of propofol, lidocaine, Magnesium sulfate
intravenous infusion of propofol 6-10 mg.kg-1.h-1, lidocaine (lidocaine 2% 400mg in 20 ml) bolus of 1.5 mg.kg-1 followed by infusion with a rate of 1.5 mg.kg-1.h-1 and magnesium sulfate 40 mg.kg-1 loading followed by infusion of 20 mg.kg-1.h-1. the effect of either Propofol injection, or ketamine injection or dexmeditomidine injection on intraoperative bleeding
DRUGIntravenous infusion of ketamine, lidocaine, Magnesium sulfate
Patients will receive intravenous infusion of Ketamine 0.1-0.2 mg.kg-1.h-1 (intravenous infusion of propofol 6-10 mg.kg-1.h-1, lidocaine (lidocaine 2% 400mg in 20 ml) bolus of 1.5 mg.kg-1 followed by infusion with a rate of 1.5 mg.kg-1.h-1 and magnesium sulfate 40 mg.kg-1 loading followed by infusion of 20 mg.kg-1.h-1. dose of 1 mg.kg-1), lidocaine bolus of 1.5 mg.kg-1 followed by infusion with a rate of 1.5 mg.kg-1.h-1 and magnesium sulfate 40 mg.kg-1 loading followed by infusion of 20 mg.kg-1.h-1.
DRUGIntravenous infusion of dexmedetomidine, lidocaine, Magnesium sulfate
Dexmeditomidine (Precedex® 200 mcg.2ml-1) with a rate of 0.2-0.6 mcg.Kg-1.h-1. lidocaine bolus of 1.5 mg.kg-1 followed by infusion with a rate of 1.5 mg.kg-1.h-1 and magnesium sulfate 40 mg.kg-1 loading followed by infusion of 20 mg.kg-1.h-1
Sponsors
Ain Shams University
Study design
Allocation
RANDOMIZED
Intervention model
PARALLEL
Primary purpose
PREVENTION
Masking
QUADRUPLE (Subject, Caregiver, Investigator, Outcomes Assessor)
Intervention model description
compare the effect of; propofol- lidocaine-magnesium and ketamine- lidocaine- magnesium infusions to dexmedetomidine- lidocaine- magnesium infusion on surgical field quality in patients undergoing nasal surgeries.
Eligibility
Sex/Gender
ALL
Age
18 Years to 60 Years
Healthy volunteers
No
Inclusion criteria
* ASA I-II, * scheduled for elective nasal surgery
Exclusion criteria
* Patients with uncontrolled hypertension. * Patients with cardiac disease. * Patients with renal, hepatic or cerebral insufficiency. * Patients with coagulopathy or receiving drugs influencing blood coagulation. * Anaemia, haemoglobinopathies or polycythemia. * Pregnancy. * Patients with known sensitivity to any of the study drug.
Design outcomes
Primary
| Measure | Time frame | Description |
|---|---|---|
| surgical field using the average category scale (ACS). | During the operation | Degree of surgical field bleeding |
Secondary
| Measure | Time frame | Description |
|---|---|---|
| sedation using Ramsy sedation score | First hour postoperative | Degree of sedation using Ramsy sedation score |
Countries
Egypt
Contacts
Primary ContactRANIA M Hussien, MD
Backup ContactFathy Tash, MD
Outcome results
None listed