Remifentanil Dosing Regimes for Anesthesia in Bariatric Surgery: Characteristics of Early Recovery

NCT ID: NCT04690088

Last Updated: 2020-12-30

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

Total Enrollment

31 participants

Study Classification

OBSERVATIONAL

Study Start Date

2019-10-10

Study Completion Date

2020-02-10

Brief Summary

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Early recovery characteristics are important for patients' safety and operating room turnover. Our aim was to compare fundamental methods for dosing remifentanil during morbid obesity surgeries: a manual infusion and a target-controlled infusion (TCI). Throughout study, patient's recovery time was tracked and compared between the groups.

Detailed Description

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Introduction: The population of overweighted patients is increasing dramatically, therefore physicians face them in their daily practice (1-2). There are many guidelines showing the dose counting methods of intravenous anesthetics, but none of them are perfectly good for morbidity obese patients (3). Early recovery characteristics are important for patients' safety and operating room turnover (4).

Aim: Our aim was to compare fundamental methods for dosing remifentanil during morbid obesity surgeries: a manual infusion and a target-controlled infusion (TCI). Throughout study, patient's recovery time was tracked and compared between the groups.

Methods: 31 patients were evaluated who underwent bariatric surgery in Hospital of Lithuanian University of Health Sciences. All of them had received sevoflurane/remifentanil anaesthesia. Remifentanil infusion was randomly assigned to a manual (control group) or to a TCI (case group) method. We had evaluated patients' hemodynamics (arterial blood pressure, heart rate, saturation), spontaneous breathing and airway reflexes recovery time, time of extubation, eye opening, recovery of orientation and start of the following oral command. Also we had registered concentrations of remifentanil in the blood (according to automatic infusion pump) while using TCI method.

Conditions

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Morbid Obesity

Keywords

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morbid obesity remifentanil manual infusion target - controlled infusion

Study Design

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Observational Model Type

COHORT

Study Time Perspective

PROSPECTIVE

Study Groups

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Manual infusion (control) group

No interventions assigned to this group

TCI (case) group

No interventions assigned to this group

Eligibility Criteria

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Inclusion Criteria

* Morbid patients to whom, according guidelines (BMI \> 45 or BMI \> 35 and chronic disease) bariatric surgery is indicated.
* Patient's approval.

Exclusion Criteria

* Patients, younger than 18 years old.
* Patients who are higher than III ASA class.
* Patients who have higher sensibility to medications that are used during anesthesia.
* Patients with phycological disorders.
* Patients who can not fully communicate because of language barriers.
* Patients with surgical complications.
* Patient's disapproval.
Minimum Eligible Age

28 Years

Maximum Eligible Age

57 Years

Eligible Sex

ALL

Accepts Healthy Volunteers

Yes

Sponsors

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Lithuanian University of Health Sciences

OTHER

Sponsor Role lead

Responsible Party

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Paulina Aldakauskaite

resident doctor

Responsibility Role PRINCIPAL_INVESTIGATOR

Locations

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Lithuanian University of Health Sciences

Kaunas, , Lithuania

Site Status

Countries

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Lithuania

References

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Clinical Guidelines on the Identification, Evaluation, and Treatment of Overweight and Obesity in Adults--The Evidence Report. National Institutes of Health. Obes Res. 1998 Sep;6 Suppl 2:51S-209S. No abstract available.

Reference Type BACKGROUND
PMID: 9813653 (View on PubMed)

Cheymol G. Effects of obesity on pharmacokinetics implications for drug therapy. Clin Pharmacokinet. 2000 Sep;39(3):215-31. doi: 10.2165/00003088-200039030-00004.

Reference Type BACKGROUND
PMID: 11020136 (View on PubMed)

Adams JP, Murphy PG. Obesity in anaesthesia and intensive care. Br J Anaesth. 2000 Jul;85(1):91-108. doi: 10.1093/bja/85.1.91. No abstract available.

Reference Type BACKGROUND
PMID: 10927998 (View on PubMed)

Michelsen LG, Hug CC Jr. The pharmacokinetics of remifentanil. J Clin Anesth. 1996 Dec;8(8):679-82. doi: 10.1016/s0952-8180(96)00179-1.

Reference Type BACKGROUND
PMID: 8982900 (View on PubMed)

Egan TD, Kern SE, Muir KT, White J. Remifentanil by bolus injection: a safety, pharmacokinetic, pharmacodynamic, and age effect investigation in human volunteers. Br J Anaesth. 2004 Mar;92(3):335-43. doi: 10.1093/bja/aeh075.

Reference Type BACKGROUND
PMID: 14970134 (View on PubMed)

Related Links

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https://www.ovid.com/product-details.496.html

Cortrnez L I, Anderson B J. Current Opinion in Anaesthesiology 2018; 31(4):415-422.

https://link.springer.com/article/10.2165/00003088-199529020-00003

Egan T D. Remyfentanil Pharmacocinetics and Pharmacodynamics. Clin. Pharmacokinet 1995; 29:80.

https://vapris.vvkt.lt/vvkt-web/public/medications/view/20375

Valstybinė vaistų kontrolės tarnyba. Remifentanil Kabi.

Other Identifiers

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BEC - MF - 93

Identifier Type: -

Identifier Source: org_study_id