Depth of Anesthesia, Postoperative Recovery, Rhinoplasty, Surgical Bleeding
Conditions
Keywords
processed EEG, qCON, qNOX, rhinoplasty, esmolol, TIVA, recovery quality, controlled hypotension
Brief summary
This prospective observational study evaluates intraoperative processed electroencephalography parameters in adult patients undergoing elective rhinoplasty under total intravenous anesthesia with controlled hypotension. The study focuses on qCON and qNOX values during anesthesia, their relationship with early postoperative recovery, and their association with intraoperative surgical bleeding and surgical field quality.
Detailed description
Controlled hypotension is commonly used during rhinoplasty to improve surgical field visibility and reduce bleeding. However, the adequacy and safety of controlled hypotension should not be evaluated only by hemodynamic variables. Processed EEG monitoring may provide additional information about hypnotic depth and the probability of response to nociceptive stimulation. In this prospective observational study, adult patients undergoing elective rhinoplasty under general anesthesia were monitored with standard ASA monitoring and processed EEG monitoring. Total intravenous anesthesia was maintained with propofol and remifentanil. Esmolol infusion was used as part of the controlled hypotension strategy. Intraoperative qCON and qNOX values, hemodynamic parameters, surgical bleeding scores, anesthetic drug consumption, extubation time, time to reach Aldrete score ≥9, and early postoperative cognitive recovery were recorded. The primary objective is to evaluate the intraoperative course of qCON and qNOX values during controlled hypotension. Secondary objectives are to assess the relationship of processed EEG parameters with recovery quality, early postoperative cognitive status, anesthetic drug consumption, and surgical field bleeding.
Interventions
None listed
Sponsors
Gazi University
Study design
Observational model
COHORT
Time perspective
PROSPECTIVE
Eligibility
Sex/Gender
ALL
Age
18 Years to No maximum
Healthy volunteers
No
Inclusion criteria
* Patients aged 18 years or older * Patients scheduled for elective rhinoplasty * Patients classified as ASA physical status I-II * Patients planned to undergo general anesthesia with total intravenous anesthesia * Patients in whom frontal processed EEG electrodes can be applied * Patients who provide written informed consent
Exclusion criteria
* Emergency surgery * Severe neurological disease * Scalp lesion or marked dermatitis preventing processed EEG electrode placement * Communication or hearing impairment preventing postoperative assessment * Marked hemodynamic instability * Multiple trauma or need for postoperative intensive care unit admission * Pregnancy
Design outcomes
Primary
| Measure | Time frame | Description |
|---|---|---|
| Intraoperative qCON and qNOX values during controlled hypotension | From baseline before anesthesia induction until the end of surgery, up to approximately 150 minutes intraoperatively. | qCON and qNOX values obtained by processed EEG monitoring will be recorded at predefined intraoperative time points. qCON will be used as an index of hypnotic depth, and qNOX will be used as an index of the probability of response to nociceptive stimulation. |
Secondary
| Measure | Time frame | Description |
|---|---|---|
| Heart rate during controlled hypotension | From baseline before anesthesia induction until the end of surgery, up to approximately 150 minutes intraoperatively. | Heart rate will be recorded at predefined intraoperative time points to evaluate hemodynamic stability. |
Countries
Turkey (Türkiye)
Contacts
STUDY_CHAIRNurdan Bedirli, MD
Gazi University
Outcome results
None listed