Monitoring of Adequate Course of General Anesthesia

NCT ID: NCT03331692

Last Updated: 2017-11-06

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

208 participants

Study Classification

INTERVENTIONAL

Study Start Date

2012-04-20

Study Completion Date

2014-07-14

Brief Summary

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Clinical monitoring is the most common method of adjustment of the appropriate level of general anesthesia. However, the episodes of intraoperative awareness are still reported, suggesting that clinical observations may not be sufficient in some cases. The objective of the study was to compare the efficacy of clinical and instrumental neuromonitoring with auditory evoked potentials in intraoperative analysis of the proper level of general anesthesia.

The patients scheduled for elective surgery were included into the study, and randomly divided into two groups. Patients in the first group (TIVA group) underwent intravenous, in the second group (VA group) underwent volatile anesthesia. The adequacy of anesthesia was analyzed with standard clinical parameters. All the participants were instrumentally monitored with AAI index. After the anesthesia patients received a questionnaire with the questions regarding possible intraoperative awareness.

Detailed Description

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Conditions

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Monitoring of Depth of Anesthesia AAI Index

Study Design

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Allocation Method

RANDOMIZED

Intervention Model

PARALLEL

Participants are assigned to intravenous or volatile anesthesia. In both groups both the clinical and instrumental monitoring of the proper level of anesthesia was analyzed.
Primary Study Purpose

PREVENTION

Blinding Strategy

DOUBLE

Participants Caregivers
During the anesthesia, in all the participants an AAI-A line ARX index was continuously monitored. The electrodes were placed after the induction of anesthesia.

Intraoperatively, both auditory evoked potentials with AAI index and electroencephalogram with burst suppression analysis was recorded. Recorded data were blinded for anesthesiologists, so were not used for analysis of level of anesthesia during surgery.

Study Groups

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TIVA group

The participants scheduled for elective ENT procedures or for elective discectomy. The surgery was performed under totally intravenous anesthesia.

During procedure, monitoring of the proper level of general anesthesia both clinical and instrumental was performed.

Group Type OTHER

monitoring of the proper level of general anesthesia

Intervention Type OTHER

The monitoring of the adequate level of general anesthesia was performed both clinically and instrumentally.

VA group

The participants scheduled for elective ENT procedures or for elective discectomy. The surgery was performed under volatile anesthesia. During procedure, monitoring of the proper level of general anesthesia both clinical and instrumental was performed.

Group Type OTHER

monitoring of the proper level of general anesthesia

Intervention Type OTHER

The monitoring of the adequate level of general anesthesia was performed both clinically and instrumentally.

Interventions

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monitoring of the proper level of general anesthesia

The monitoring of the adequate level of general anesthesia was performed both clinically and instrumentally.

Intervention Type OTHER

Other Intervention Names

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clinical monitoring instrumental monitoring

Eligibility Criteria

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Inclusion Criteria

* patients scheduled for ENT procedures or discectomy,
* preoperative health status I or II according to ASA score.

Exclusion Criteria

* patients below 18 or above 61 year old,
* ASA status III or higher,
* patients suffering from: (i) hearing problems or tinnitus, (ii) chronic inflammation of the ear, (iii) epilepsy, and (iv) mental disorders,
* pregnancy.
Minimum Eligible Age

18 Years

Maximum Eligible Age

61 Years

Eligible Sex

ALL

Accepts Healthy Volunteers

Yes

Sponsors

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Military Institute od Medicine National Research Institute

OTHER

Sponsor Role lead

Responsible Party

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Dariusz Tomaszewski

Adjunct professor

Responsibility Role PRINCIPAL_INVESTIGATOR

Locations

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Department of Anesthesiology and Intensive Therapy

Warsaw, , Poland

Site Status

Countries

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Poland

References

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Saper CB, Chou TC, Scammell TE. The sleep switch: hypothalamic control of sleep and wakefulness. Trends Neurosci. 2001 Dec;24(12):726-31. doi: 10.1016/s0166-2236(00)02002-6.

Reference Type BACKGROUND
PMID: 11718878 (View on PubMed)

Nelson LE, Guo TZ, Lu J, Saper CB, Franks NP, Maze M. The sedative component of anesthesia is mediated by GABA(A) receptors in an endogenous sleep pathway. Nat Neurosci. 2002 Oct;5(10):979-84. doi: 10.1038/nn913.

Reference Type BACKGROUND
PMID: 12195434 (View on PubMed)

Lu J, Nelson LE, Franks N, Maze M, Chamberlin NL, Saper CB. Role of endogenous sleep-wake and analgesic systems in anesthesia. J Comp Neurol. 2008 Jun 1;508(4):648-62. doi: 10.1002/cne.21685.

Reference Type BACKGROUND
PMID: 18383504 (View on PubMed)

Ghoneim MM, Block RI, Haffarnan M, Mathews MJ. Awareness during anesthesia: risk factors, causes and sequelae: a review of reported cases in the literature. Anesth Analg. 2009 Feb;108(2):527-35. doi: 10.1213/ane.0b013e318193c634.

Reference Type BACKGROUND
PMID: 19151283 (View on PubMed)

Wang DS, Orser BA. Inhibition of learning and memory by general anesthetics. Can J Anaesth. 2011 Feb;58(2):167-77. doi: 10.1007/s12630-010-9428-8. Epub 2010 Dec 23.

Reference Type BACKGROUND
PMID: 21181566 (View on PubMed)

Sebel PS, Bowdle TA, Ghoneim MM, Rampil IJ, Padilla RE, Gan TJ, Domino KB. The incidence of awareness during anesthesia: a multicenter United States study. Anesth Analg. 2004 Sep;99(3):833-839. doi: 10.1213/01.ANE.0000130261.90896.6C.

Reference Type BACKGROUND
PMID: 15333419 (View on PubMed)

Osterman JE, Hopper J, Heran WJ, Keane TM, van der Kolk BA. Awareness under anesthesia and the development of posttraumatic stress disorder. Gen Hosp Psychiatry. 2001 Jul-Aug;23(4):198-204. doi: 10.1016/s0163-8343(01)00142-6.

Reference Type BACKGROUND
PMID: 11543846 (View on PubMed)

Other Identifiers

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06101968-05

Identifier Type: -

Identifier Source: org_study_id