One-year Mortality After Surgery and Low Bispectral Index

NCT ID: NCT01198639

Last Updated: 2018-02-15

Study Results

Results pending

The study team has not published outcome measurements, participant flow, or safety data for this trial yet. Check back later for updates.

Basic Information

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Recruitment Status

COMPLETED

Clinical Phase

NA

Total Enrollment

2044 participants

Study Classification

INTERVENTIONAL

Study Start Date

2010-09-13

Study Completion Date

2015-02-20

Brief Summary

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A correlation between deep anesthesia (defined as time with Bispectral Index (BIS) lower than 45) and death within 1 yr after surgery has previously been reported. In order to confirm or refute these findings, the investigators have designed a study which compares two methods of administration for total intravenous anesthesia (propofol and remifentanil):

* manual administration: the anesthesiologists are instructed to maintain the BIS value between 40 and 60.
* closed loop administration: an algorithm is used to maintain the BIS value between 40 and 60.

Based on previous studies, the amount of time that BIS is maintained above 40 is greater when anesthetics agents are administered using closed loop compared with manual administration.

Detailed Description

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Conditions

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General Anesthesia

Study Design

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Allocation Method

RANDOMIZED

Intervention Model

PARALLEL

Primary Study Purpose

TREATMENT

Blinding Strategy

DOUBLE

Participants Outcome Assessors

Study Groups

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manual administration of iv anesthetics

Group Type ACTIVE_COMPARATOR

manual administration of iv anesthetics (propofol and remifentanil) using the Toolbox platform

Intervention Type DEVICE

the anesthesiologists are instructed to maintain the BIS values between 40 and 60 throughout anesthesia using target controlled infusion method

closed-loop administration of iv anesthetics

Group Type EXPERIMENTAL

closed-loop administration of iv anesthetics (propofol and remifentanil) using the Toolbox platform

Intervention Type DEVICE

an algorithm is used to maintain automatically the BIS values between 40 and 60

Interventions

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manual administration of iv anesthetics (propofol and remifentanil) using the Toolbox platform

the anesthesiologists are instructed to maintain the BIS values between 40 and 60 throughout anesthesia using target controlled infusion method

Intervention Type DEVICE

closed-loop administration of iv anesthetics (propofol and remifentanil) using the Toolbox platform

an algorithm is used to maintain automatically the BIS values between 40 and 60

Intervention Type DEVICE

Eligibility Criteria

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Inclusion Criteria

* American Society of Anesthesiology patient classification status I, II and III
* patients aged between 50 and 85 years old
* born in France
* surgical procedures lasting more than one hour

Exclusion Criteria

* American Society of Anesthesiology patient classification status IV
* patients born out of France
* pace-maker
* surgical procedure on the skull or avoiding an adequate positioning of the bispectral index electrode dementia, history of central nervous system disease (tumor, vascular event, Parkinson disease, ...)
* psychiatric illness (severe depression or psychosis), patients receiving a psychotropic treatment
* anesthesia performed during the year before inclusion in this study except for diagnostic procedures
* allergy to propofol, soja, peanuts, or to sufentanil, remifentanil, or morphine, to a myorelaxant or to an excipient,
* hypersensibility to sufentanil, to remifentanil, or to other derivate of fentanyl
Minimum Eligible Age

50 Years

Maximum Eligible Age

85 Years

Eligible Sex

ALL

Accepts Healthy Volunteers

No

Sponsors

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Hopital Foch

OTHER

Sponsor Role lead

Responsible Party

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Responsibility Role SPONSOR

Principal Investigators

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Marc Fischler, MD

Role: STUDY_CHAIR

Hôpital Foch

Locations

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CHU Victor Dupuy

Argenteuil, , France

Site Status

CHU Besançon

Besançon, , France

Site Status

Hôpitaux Universitaires Paris-Seine St Denis CHU Avicenne

Bobigny, , France

Site Status

Clinique Saint Augustin

Bordeaux, , France

Site Status

Clinique Saint Vincent de Paul

Bourgoin, , France

Site Status

Hôpital Femme-Mère-Enfant

Bron, , France

Site Status

CH de Chartres Louis Pasteur

Chartres, , France

Site Status

H.I.A Percy

Clamart, , France

Site Status

Centre Jean Perrin

Clermont-Ferrand, , France

Site Status

Clinique des Deux Caps

Coquelles, , France

Site Status

Clinique Fontaine-lès-Dijon

Dijon, , France

Site Status

CHU de Grenoble

Grenoble, , France

Site Status

Institut Hospitalier Franco Britannique

Levallois-Perret, , France

Site Status

Institut Paoli-Calmettes

Marseille, , France

Site Status

HIA du Val de Grace

Paris, , France

Site Status

HEGP

Paris, , France

Site Status

CHI Poissy/St Germain-en-Laye

Poissy, , France

Site Status

CHU de Rouen

Rouen, , France

Site Status

Hia Begin

Saint-Mandé, , France

Site Status

Hôpital Foch

Suresnes, , France

Site Status

CHU Rangueil

Toulouse, , France

Site Status

CHU Tours

Tours, , France

Site Status

Countries

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France

References

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Liu N, Chazot T, Genty A, Landais A, Restoux A, McGee K, Laloe PA, Trillat B, Barvais L, Fischler M. Titration of propofol for anesthetic induction and maintenance guided by the bispectral index: closed-loop versus manual control: a prospective, randomized, multicenter study. Anesthesiology. 2006 Apr;104(4):686-95. doi: 10.1097/00000542-200604000-00012.

Reference Type BACKGROUND
PMID: 16571963 (View on PubMed)

Cantraine FR, Coussaert EJ. The first object oriented monitor for intravenous anesthesia. J Clin Monit Comput. 2000 Jan;16(1):3-10. doi: 10.1023/a:1009904805940.

Reference Type BACKGROUND
PMID: 12578088 (View on PubMed)

Lindholm ML, Traff S, Granath F, Greenwald SD, Ekbom A, Lennmarken C, Sandin RH. Mortality within 2 years after surgery in relation to low intraoperative bispectral index values and preexisting malignant disease. Anesth Analg. 2009 Feb;108(2):508-12. doi: 10.1213/ane.0b013e31818f603c.

Reference Type RESULT
PMID: 19151279 (View on PubMed)

Monk TG, Saini V, Weldon BC, Sigl JC. Anesthetic management and one-year mortality after noncardiac surgery. Anesth Analg. 2005 Jan;100(1):4-10. doi: 10.1213/01.ANE.0000147519.82841.5E.

Reference Type RESULT
PMID: 15616043 (View on PubMed)

Mahr N, Bouhake Y, Chopard G, Liu N, Boichut N, Chazot T, Claveau M, Vettoretti L, Tio G, Pili-Floury S, Samain E, Besch G. Postoperative Neurocognitive Disorders After Closed-Loop Versus Manual Target Controlled-Infusion of Propofol and Remifentanil in Patients Undergoing Elective Major Noncardiac Surgery: The Randomized Controlled Postoperative Cognitive Dysfunction-Electroencephalographic-Guided Anesthetic Administration Trial. Anesth Analg. 2021 Oct 1;133(4):837-847. doi: 10.1213/ANE.0000000000005278.

Reference Type DERIVED
PMID: 33181558 (View on PubMed)

Other Identifiers

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2009/30

Identifier Type: -

Identifier Source: org_study_id

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