Early Postoperative Cognitive Dysfunction After Closed Loop Anesthesia vs Inhalational Anesthesia or TIVA

NCT ID: NCT02656901

Last Updated: 2016-07-06

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

132 participants

Study Classification

INTERVENTIONAL

Study Start Date

2016-01-31

Study Completion Date

2016-06-30

Brief Summary

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This study is designed to test the hypothesis that closed loop system reduces post operative cognitive dysfunction incidence 15 min after anesthesia more than desflurane, sevorane, total intravenous anesthesia manually guided by bispectral index in urologic surgical patients.

The secondary aim is to evaluate the postoperative cognitive impairment in in elderly vs younger surgical patients.

Detailed Description

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Postoperative cognitive dysfunction (POCD) is a transient cognitive impairment manifested by compromised memory and concentration with altered performance on intellectual tasks that can affect patients of any age but it is more frequent in advanced age people after anesthesia.

Recently clinical research has demonstrated the efficacy of computer- controlled endovenous drug delivery system guided by bispectral index score (BIS) of the electroencephalogram as the control variable. The BIS closed loop (CL) titration of propofol and remifentanyl target control infusion provides clinically adequate anesthesia with stability of cardiovascular parameters and favorable patients outcomes, including decreasing drug consumption and shortened postoperative recovery times when compared with manual control infusion.

Conditions

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Postoperative Cognitive Dysfunction

Study Design

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Allocation Method

RANDOMIZED

Intervention Model

PARALLEL

Primary Study Purpose

SCREENING

Blinding Strategy

DOUBLE

Participants Caregivers

Study Groups

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Auto Total endovenous anesthesia

The closed loop delivering as already approved by ClinicalTrials.gov Identifier: NCT00392158

Group Type ACTIVE_COMPARATOR

auto total endovenous anesthesia

Intervention Type DEVICE

a closed-loop controller guided by the BIS steering the infusion pumps (Alaris Medical UK Ldt, Hants, Uk) as already approved by ClinicalTrials.gov Identifier: NCT00392158

Manual Desflurane anesthesia

The anesthesia will be maintained with desflurane to target the BIS of 50.

Group Type SHAM_COMPARATOR

Manual Desflurane anesthesia

Intervention Type DEVICE

General anesthesia will be maintained with desflurane (Baxter D-Vapor Desflurane Vaporiser) to obtain a BIS value as close as possible to 50 and between 40

Manual sevoflurane anesthesia

The anesthesia will be maintained with sevoflurane to target the BIS of 50.

Group Type SHAM_COMPARATOR

Manual Sevoflurane anesthesia

Intervention Type DEVICE

General anesthesia will be maintained with sevoflurane ( Baxter Vapour 2000 Sevoflurane Vapouriser) to obtain a BIS value as close as possible to 50 and between 40 and 60.

Manual total endovenous anestesia

In ManualTIVA group, the anesthesia will be maintained with propofol to target the BIS of 50

Group Type SHAM_COMPARATOR

Manual total endovenous anesthesia

Intervention Type DEVICE

In ManualTIVA group, the anesthesia will be maintained with propofol (Injectomat TIVA Agilia, Fresenius Kabi, Bad Hamburg, Germany) to obtain a BIS value as close as possible to 50 and between 40 and 60.

Interventions

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auto total endovenous anesthesia

a closed-loop controller guided by the BIS steering the infusion pumps (Alaris Medical UK Ldt, Hants, Uk) as already approved by ClinicalTrials.gov Identifier: NCT00392158

Intervention Type DEVICE

Manual Desflurane anesthesia

General anesthesia will be maintained with desflurane (Baxter D-Vapor Desflurane Vaporiser) to obtain a BIS value as close as possible to 50 and between 40

Intervention Type DEVICE

Manual Sevoflurane anesthesia

General anesthesia will be maintained with sevoflurane ( Baxter Vapour 2000 Sevoflurane Vapouriser) to obtain a BIS value as close as possible to 50 and between 40 and 60.

Intervention Type DEVICE

Manual total endovenous anesthesia

In ManualTIVA group, the anesthesia will be maintained with propofol (Injectomat TIVA Agilia, Fresenius Kabi, Bad Hamburg, Germany) to obtain a BIS value as close as possible to 50 and between 40 and 60.

Intervention Type DEVICE

Other Intervention Names

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AutoTIVA DES SEVO Manual TIVA

Eligibility Criteria

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Inclusion Criteria

* Patients aged above 18 years
* Patients undergoing elective urologic surgery under general anesthesia expected 2 hours
* American Society of Anesthesiology physical status II- III

Exclusion Criteria

* Patients with body mass index greater than 30,
* Patients with clinically significant cardiopulmonary, hepatic, renal disorders, neurological, psychiatric or metabolic disease
* Patients unable to read and write and with impaired hearing
Minimum Eligible Age

18 Years

Eligible Sex

ALL

Accepts Healthy Volunteers

No

Sponsors

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University of Foggia

OTHER

Sponsor Role lead

Responsible Party

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Cotoia Antonella

Prof.

Responsibility Role PRINCIPAL_INVESTIGATOR

Principal Investigators

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Antonella Cotoia, MD, PhD

Role: PRINCIPAL_INVESTIGATOR

University of Foggia

Locations

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University of Foggia

Foggia, Foggia, Italy

Site Status

Countries

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Italy

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 RESULT
PMID: 16571963 (View on PubMed)

Liu N, Chazot T, Hamada S, Landais A, Boichut N, Dussaussoy C, Trillat B, Beydon L, Samain E, Sessler DI, Fischler M. Closed-loop coadministration of propofol and remifentanil guided by bispectral index: a randomized multicenter study. Anesth Analg. 2011 Mar;112(3):546-57. doi: 10.1213/ANE.0b013e318205680b. Epub 2011 Jan 13.

Reference Type RESULT
PMID: 21233500 (View on PubMed)

Liu N, Chazot T, Trillat B, Michel-Cherqui M, Marandon JY, Law-Koune JD, Rives B, Fischler M; Foch Lung Transplant Group. Closed-loop control of consciousness during lung transplantation: an observational study. J Cardiothorac Vasc Anesth. 2008 Aug;22(4):611-5. doi: 10.1053/j.jvca.2008.04.022. Epub 2008 Jun 25.

Reference Type RESULT
PMID: 18662642 (View on PubMed)

Liu N, Lory C, Assenzo V, Cocard V, Chazot T, Le Guen M, Sessler DI, Journois D, Fischler M. Feasibility of closed-loop co-administration of propofol and remifentanil guided by the bispectral index in obese patients: a prospective cohort comparison. Br J Anaesth. 2015 Apr;114(4):605-14. doi: 10.1093/bja/aeu401. Epub 2014 Dec 10.

Reference Type RESULT
PMID: 25500680 (View on PubMed)

Other Identifiers

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43/CE/2014

Identifier Type: -

Identifier Source: org_study_id

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