Effect of Sevoflurane in Postoperative Troponin I Levels in Children Undergoing Congenital Heart Defects Surgery

NCT ID: NCT03630796

Last Updated: 2018-09-05

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

UNKNOWN

Clinical Phase

PHASE4

Total Enrollment

66 participants

Study Classification

INTERVENTIONAL

Study Start Date

2018-08-20

Study Completion Date

2019-12-31

Brief Summary

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The main purpose of this study is to compare myocardial injury of patients undergoing congenital cardiac defects repair surgery (RACHS Risk Score one, two or three) under total intravenous anesthesia compared to inhalation anesthesia with sevoflurane. The primary aim of the study is to evaluate the troponin I levels in patients following congenital heart surgery and elucidate if one of the two anesthetic techniques (TIVA x inhalation anesthesia) is more effective in reducing troponin I levels in the first 72h after surgery..

Sixty six are planned to be included in the study and the follow-up will take approximately 3 days for the primary outcome.

As a secondary outcome evaluate the BNP, CPK and CKMB postoperative levels in the same period (72h), also ICU and hospital lengh of stay (LOS), duration of mechanical ventilation, inotropic/vasoactive drugs use and incidence of renal injury (according to pediatric RIFLE score).

Detailed Description

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Conditions

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Congenital Heart Defects

Study Design

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Allocation Method

RANDOMIZED

Intervention Model

PARALLEL

Primary Study Purpose

TREATMENT

Blinding Strategy

SINGLE

Participants

Study Groups

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Sevoflurane

Anesthetic induction with sevoflurane by mask 3-8% and fresh gas flow 2-8 l/min (FiO2 50-100%) followed by ketamine 1-2 mg/kg, midazolam 0,1-0,5 mg/kg, fentanyl 2-4 mcg/kg and pancuronium 0,1 mg/kg.

After orotracheal intubation, anesthesia is maintained with fentanyl 10 - 30 mcg/kg according to clinical needs and sevoflurane 1-3% (end-tidal concentration) before and after cardiopulmonary bypass. Specifically during cardiopulmonary bypass extra fentanyl 1-5 mcg/kg and pancuronium 0,1 mg/kg will be administered and the sevoflurane sustained 1-3% in a specific sevoflurane vaporizer included in the CPB machine.

Pressure-controlled ventilation will be applied to both groups objectifying normocarbia and normoxia.

Ringer's lactate (RL) will be used as crystalloid solution for fluid therapy.

Group Type ACTIVE_COMPARATOR

Sevoflurane

Intervention Type DRUG

Use of sevoflurane (compared to total intravenous anesthesia) in congenital heart deffects surgeries.

Intravenous anesthetics (TIVA)

Anesthetic induction with ketamine 1-3 mg/kg, midazolam 0,1-0,5 mg/kg, fentanyl 2-4 mcg/kg and pancuronium 0,1 mg/kg after preoxygenation with FiO2 between 50-100% and fresh gas flow 4-8 l/min.

After orotracheal intubation, anesthesia is maintained with fentanyl 10 - 30 mcg/kg according to clinical needs and continuous infusion of midazolam and ketamine 0,2-0,8 mg/kg/h and 1-2 mg/kg/h respectively before and after cardiopulmonary bypass. Specifically during cardiopulmonary bypass extra fentanyl 1-5 mcg/kg, midazolam 0,1-0,5 mg/kg and pancuronium 0,1 mg/kg will be administered.

Pressure-controlled ventilation will be applied to both groups objectifying normocarbia and normoxia.

Ringer's lactate (RL) will be used as crystalloid solution for fluid therapy.

Group Type OTHER

TIVA

Intervention Type DRUG

Total intravenous anesthesia

Interventions

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Sevoflurane

Use of sevoflurane (compared to total intravenous anesthesia) in congenital heart deffects surgeries.

Intervention Type DRUG

TIVA

Total intravenous anesthesia

Intervention Type DRUG

Eligibility Criteria

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Inclusion Criteria

* Written informed consent (signed by the parents)
* Scheduled Congenital Heart Defect Repair Surgery RACHS Risk Score 1, 2 or 3. On-pump Surgery
* Age: 2 years old (completed) or younger
* Patients without previous kidney disease or any contraindication for inhaled anesthesia (including previous unusual response to an anesthetic agent)
* No previous general anesthesia in the last 30 days.

Exclusion Criteria

* Emergency surgery
* Off-pump surgery (surgery plan changed by the surgeon after patient's randomization)
* Refuse to take part of the study or ask to leave the trial
Maximum Eligible Age

24 Months

Eligible Sex

ALL

Accepts Healthy Volunteers

No

Sponsors

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Instituto do Coracao

OTHER_GOV

Sponsor Role lead

Responsible Party

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Filomena R B G Galas

Phd MD

Responsibility Role PRINCIPAL_INVESTIGATOR

Locations

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Incor - Heart Institute - University of Sao Paulo

São Paulo, , Brazil

Site Status RECRUITING

Countries

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Brazil

Facility Contacts

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Filomena RG Galas

Role: primary

+551126615232

Other Identifiers

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4343.19.009

Identifier Type: -

Identifier Source: org_study_id

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