Propofol Versus Sevoflurane During FESS

NCT ID: NCT04619160

Last Updated: 2020-11-06

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

UNKNOWN

Clinical Phase

PHASE4

Total Enrollment

60 participants

Study Classification

INTERVENTIONAL

Study Start Date

2020-03-01

Study Completion Date

2021-03-31

Brief Summary

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Good surgical conditions are crucial for an optimal surgery result and safe procedure. Minimal blood loss in the surgical field is one of the most important conditions to maintain a good visualization, especially in surgeries with a small surgical field such as a FESS (functional endoscopic sinus surgery). The perioperative blood loss is determined by the main arterial and venous pressure, the local pressure and the capillary vascular filling pressure.

It has been proposed that propofol is a venodilator, which increases the blood flow, but decreases the capillary pressure. On the contrary, sevoflurane might act mainly on the arterioles, which causes an increase in the capillary pressure. In a previous study it has been demonstrated that despite blood pressure maintenance, propofol causes less bleeding during spinal surgery than sevoflurane.

The main aim of this study was to compare both anaesthetics on the perioperative bleeding and haemodynamics during FESS. Secondary, the postoperative nausea, vomiting, pain scores, surgery duration and length of stay at the post-anesthesia care unit will be evaluated.

Detailed Description

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2 X 30 patients which are planned for FESS surgery are randomized in a sevoflurane group or propofol group.

All patients will be induced with propofol (target-controlled infusion (TCI) 4 µg/mL) and remifentanil (TCI 4 ng/mL) and receive a multimodal intravenous analgesia.

Patients in the propofol group will receive further intravenous propofol until a bispectral index (BIS) value of 50 is reached.

The intravenous drip of propofol will be stopped after induction in the sevoflurane group and patients will receive sevoflurane as inhalation anaesthetic (1 MAC) until a BIS-value of 50. The surgeon will be blinded for patient allocation.

The surgical conditions will be graded postoperatively by the surgeon who performed the operation using the validated Boezaart grading scale. The endoscopic images will be evaluated in addition by 3 blinded surgeons using this same scale.

Besides the surgical conditions, haemodynamic parameters, nausea and vomiting scores (PONV), Visual Analogue Score (VAS), surgery duration, length of stay at the post-anesthesia care unit and postoperative analgesia and anti-emetics are registered.

Conditions

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Sinus Infection Chronic

Keywords

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haemodynamic peripheral blood flow FESS

Study Design

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Allocation Method

RANDOMIZED

Intervention Model

PARALLEL

Primary Study Purpose

PREVENTION

Blinding Strategy

DOUBLE

Participants Caregivers
The surgeon and participant are blinded for randomization. The anesthesiologist is unblinded.

Study Groups

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propofol

Group Type ACTIVE_COMPARATOR

Propofol

Intervention Type DRUG

TCI 4 µg/mL start until BIS-value of 50

sevoflurane

Group Type ACTIVE_COMPARATOR

Sevoflurane

Intervention Type DRUG

start 1 MAC, until BIS-value of 50

Interventions

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Propofol

TCI 4 µg/mL start until BIS-value of 50

Intervention Type DRUG

Sevoflurane

start 1 MAC, until BIS-value of 50

Intervention Type DRUG

Eligibility Criteria

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Inclusion Criteria

* patient planned for FESS surgery

Exclusion Criteria

* patients which receive anticoagulants
* patients which have coagulation disorders
* patients with high bleeding risk
* patients with arterial hypertension
* other decided by surgeon
Minimum Eligible Age

18 Years

Eligible Sex

ALL

Accepts Healthy Volunteers

Yes

Sponsors

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Algemeen Ziekenhuis Maria Middelares

OTHER

Sponsor Role lead

Responsible Party

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Dr. Alain Kalmar, MD, PhD

Staff Anesthesist

Responsibility Role PRINCIPAL_INVESTIGATOR

Principal Investigators

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Alain F Kalmar, MD, PhD, MSc

Role: PRINCIPAL_INVESTIGATOR

Maria Middelares Hospital

Locations

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General Hospital Maria Middelares

Ghent, Oost-Vlaanderen, Belgium

Site Status RECRUITING

Countries

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Belgium

Central Contacts

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Alain F Kalmar, MD, PhD, MSc

Role: CONTACT

Phone: +32 246 17 29

Email: [email protected]

Nicky Van Der Vekens, DVM, PhD

Role: CONTACT

Phone: +32 246 1709

Email: [email protected]

Facility Contacts

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Alain F Kalmar, MD, PhD

Role: primary

Other Identifiers

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MMS.2019.043

Identifier Type: -

Identifier Source: org_study_id