Controlled Sedoanalgesia in External DCR Surgery

NCT ID: NCT05397301

Last Updated: 2022-05-31

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

44 participants

Study Classification

INTERVENTIONAL

Study Start Date

2020-02-07

Study Completion Date

2021-03-01

Brief Summary

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In our study, we aim to compare general anesthesia and controlled sedoanalgesia methods in dacryocystorhinostomy (DCR) surgery in terms of hemodynamic data, bleeding amount, postoperative complications (bleeding, pain, etc.) and anesthesia satisfaction in a prospective and randomized controlled manner.

Detailed Description

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The patients were routinely monitored in the operating room in accordance with the standard protocol for elective surgeries, and the preoperative findings (blood pressure, oxygen saturation, cardiac rhythm, peak heart rate) were recorded.

The decision of routine anesthesia was not interfered with. The data of the patients were collected as GA group if general anesthesia was applied and SA group if sedoanalgesia was applied. If general anesthesia was preferred, anesthesia induction was performed with propofol, fentanyl and rocuronium, and sevoflurane was used for anesthesia maintenance. Intravenous midazolam and dexmedetomidine infusions were administered to patients for whom sedoanalgesia was preferred. The sedation level of these patients was followed up with the Ramsay sedation scale (RSS) and capnography monitoring was performed.

Whether general anesthesia or sedoanalgesia was preferred, local anesthesia was administered to all patients by the surgical team and intraoperative hemodynamic data (mean arterial pressure, heart rate, oxygen saturation) were followed.

In addition to patients recruited for the study, hemodynamic data after induction, endotracheal intubation, surgical incision, and extubation were also recorded.

Depth of anesthesia was monitored with a bispectral index monitor for both groups.

Intraoperative bleeding amount, canal damage, etc. Intraoperative complications such as In this study, the pain levels of the patients were evaluated by visual pain score (VAS) at 0 and 30 minutes, 1st, 4th, 8th and 12th hours. Analgesic requirement, postoperative nausea-vomiting and time, duration of surgery, length of hospital stay, surgery-related complications (ecchymosis, epistaxis, hematoma, edema, etc.) were recorded. Patient and surgical team satisfaction of the patients was evaluated using a 5-point Likert Scale.

The necessary measurements of the eyes and adnexa (visual acuity, meibomian gland measurement, tear breakout time, schirmer) for which detailed eye examinations of the patients will be performed preoperatively and postoperatively on the 1st day, 1st week, 1st month, 3rd month and 6th month. tests, intraocular pressure, pupil width, lens density, corneal topography, anterior and posterior segment Optical coherence tomography, etc.) tear duct examination and lavage were performed. The patient's complaints about eye diseases were recorded. As a result of the study, in addition to local anesthesia in DCR surgery, sedoanalgesia and general anesthesia methods were compared.

Conditions

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Dacryocystorhinostomy Sedation General Anesthesia

Study Design

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Allocation Method

RANDOMIZED

Intervention Model

PARALLEL

Primary Study Purpose

TREATMENT

Blinding Strategy

DOUBLE

Participants Caregivers

Study Groups

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sedoanalgesia(SA group)

Sedoanalgesia was applied to the SA group

Group Type ACTIVE_COMPARATOR

Controlled sedoanalgesia

Intervention Type PROCEDURE

Controlled sedoanalgesia was applied with Bispectral index and dexmedetomidine

general anaesthesia (GA group)

General anaesthesia was applied to the GA group

Group Type ACTIVE_COMPARATOR

Controlled sedoanalgesia

Intervention Type PROCEDURE

Controlled sedoanalgesia was applied with Bispectral index and dexmedetomidine

Interventions

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Controlled sedoanalgesia

Controlled sedoanalgesia was applied with Bispectral index and dexmedetomidine

Intervention Type PROCEDURE

Eligibility Criteria

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Inclusion Criteria

* Primary DCR surgery to be performed
* 18 years and older patients
* Having an American Society of Anesthesiology score of 1, 2, 3
* Having approved and signed the informed consent form

Exclusion Criteria

* Patients younger than 18 years old
* Patients with an American Society of Anesthesiology score of 4 and above
* Patients who do not accept informed consent
* History of drug allergy and opioid tolerance
* Uncontrolled diabetes mellitus
* Coagulation disorder
* Cases with severe liver and kidney disease
* Those who refused to participate in the study
* They will have DCR surgery again
Minimum Eligible Age

18 Years

Eligible Sex

ALL

Accepts Healthy Volunteers

No

Sponsors

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Turkish Society of Anesthesiology and Reanimation

OTHER

Sponsor Role lead

Responsible Party

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Responsibility Role SPONSOR

Locations

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Bursa Uludağ Üniversitesi Tip Fakültesi

Bursa, Ni̇lüfer, Turkey (Türkiye)

Site Status

Countries

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Turkey (Türkiye)

References

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Ciftci F, Pocan S, Karadayi K, Gulecek O. Local versus general anesthesia for external dacryocystorhinostomy in young patients. Ophthalmic Plast Reconstr Surg. 2005 May;21(3):201-6. doi: 10.1097/01.iop.0000163317.73873.c9.

Reference Type BACKGROUND
PMID: 15942495 (View on PubMed)

Tuladhar S, Adhikari S, Bhattarai BK. Effectiveness of sedation in dacryocystorhinostomy surgery. Nepal J Ophthalmol. 2009 Jan-Jun;1(1):25-31. doi: 10.3126/nepjoph.v1i1.3670.

Reference Type BACKGROUND
PMID: 21141018 (View on PubMed)

Scawn RL, Allen MJ, Rose GE, Verity DH. Randomised, masked study of local anaesthesia administered prior to external dacryocystorhinostomy under general anaesthesia. Eye (Lond). 2019 Mar;33(3):374-379. doi: 10.1038/s41433-018-0201-5. Epub 2018 Sep 18.

Reference Type BACKGROUND
PMID: 30228368 (View on PubMed)

Eghbal MH, Sahmeddini MA. Comparison larygeal mask airway with the endotracheal tube for the external dacryocystorhionostomy surgery. A randomized clinical trial. Middle East J Anaesthesiol. 2013 Oct;22(3):283-8.

Reference Type BACKGROUND
PMID: 24649784 (View on PubMed)

Kersey JP, Sleep T, Hodgkins PR. Ocular perforation associated with local anaesthetic for dacryocystorhinostomy. Eye (Lond). 2001 Oct;15(Pt 5):671-2. doi: 10.1038/eye.2001.213. No abstract available.

Reference Type BACKGROUND
PMID: 11702990 (View on PubMed)

Apan A, Doganci N, Ergan A, Buyukkocak U. Bispectral index-guided intraoperative sedation with dexmedetomidine and midazolam infusion in outpatient cataract surgery. Minerva Anestesiol. 2009 May;75(5):239-44. Epub 2008 Dec 17.

Reference Type BACKGROUND
PMID: 19088698 (View on PubMed)

Harissi-Dagher M, Boulos P, Hardy I, Guay J. Comparison of anesthetic and surgical outcomes of dacryocystorhinostomy using loco-regional versus general anesthesia. Digit J Ophthalmol. 2008 Jan 1;14:1-6. doi: 10.5693/djo.01.2008.001. eCollection 2008.

Reference Type BACKGROUND
PMID: 29440968 (View on PubMed)

Other Identifiers

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uludaganesthesia

Identifier Type: -

Identifier Source: org_study_id