Evaluation of Equivalent Minimum Alveolar Concentration (eMAC) During Propofol/Remifentanil Anesthesia

NCT ID: NCT05789992

Last Updated: 2023-06-15

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

62 participants

Study Classification

INTERVENTIONAL

Study Start Date

2023-04-03

Study Completion Date

2023-04-29

Brief Summary

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The aim of this study is to verify the accuracy of eMAC compared to Bispectral Index (BIS) for depth and nociceptive stimulation monitoring of anesthesia during general anesthesia.

Detailed Description

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eMAC is a new index based on response surface model for evaluating anesthesia state and anti-nociceptive stimulation levels. To valid it's clinical accuracy, a protocol was designed.

Patients will be allocated to receive a specific effect-site concentration of remifentanil and propofol during tonic electrical stimulation (5s, 50mA) and intubation. The concentration combinations include the electrical stimulation combination (effector chamber concentration random: remifentanil 0-3 ng/ml, propofol 3-5 ug/ml) and the intubation combination (effector chamber concentration random: remifentanil 3-5 ng/ml, propofol 3-5 ug/ml). All combinations were decided before operation. Every combination had a 5 min equilibration period, and the vital signs (Heart Rate, Blood pressure, any body movement) and BIS, eMAC will be recorded before and after the electrical stimulation and intubation. After this period, patients will be randomly allocated to receive an intravenous anesthesia or intravenous combined anesthesia, and regular anesthesia is executed. This study only records vital signs and BIS, eMAC during maintenance period of perioperative.

Conditions

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General Anaesthesia

Study Design

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Allocation Method

RANDOMIZED

Intervention Model

PARALLEL

Primary Study Purpose

DIAGNOSTIC

Blinding Strategy

NONE

Study Groups

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Group 1 BIS under tetanic electrical stimulation

During tetanic electrical stimulation, and with propofol(random:3-5ug/ml) and remifentanil(random:0-3ng/ml), the response (body movement or hemodynamic change) was observed, and recorded it's BIS.

Group Type ACTIVE_COMPARATOR

Propofol

Intervention Type DRUG

Propofol (Random:3-5ug/ml)

Low Remifentanil

Intervention Type DRUG

Remifentanil (Random:0-3ug/ml)

tetanic electrical stimulation

Intervention Type PROCEDURE

tetanic electrical stimulation before surgery

Group 2 eMAC under tetanic electrical stimulation

During tetanic electrical stimulation or intubation, and with propofol(random:3-5ug/ml) and remifentanil(random:0-3ng/ml), the response (body movement or hemodynamic change) was observed, and recorded it's eMAC.

Group Type ACTIVE_COMPARATOR

Propofol

Intervention Type DRUG

Propofol (Random:3-5ug/ml)

Low Remifentanil

Intervention Type DRUG

Remifentanil (Random:0-3ug/ml)

tetanic electrical stimulation

Intervention Type PROCEDURE

tetanic electrical stimulation before surgery

Group 3 BIS under intubation

During intubation, and with propofol(random:3-5ug/ml) and remifentanil(random:3-5ng/ml), the response (body movement or hemodynamic change) was observed, and recorded it's BIS.

Group Type ACTIVE_COMPARATOR

Propofol

Intervention Type DRUG

Propofol (Random:3-5ug/ml)

Heigh Remifentanil

Intervention Type DRUG

Remifentanil (Random:3-5ug/ml)

Intubation

Intervention Type PROCEDURE

Endotracheal intubation before surgery

Group 4 eMAC under intubation

During intubation, and with propofol(random:3-5ug/ml) and remifentanil(random:3-5ng/ml), the response (body movement or hemodynamic change) was observed, and recorded it's eMAC.

Group Type ACTIVE_COMPARATOR

Propofol

Intervention Type DRUG

Propofol (Random:3-5ug/ml)

Heigh Remifentanil

Intervention Type DRUG

Remifentanil (Random:3-5ug/ml)

Intubation

Intervention Type PROCEDURE

Endotracheal intubation before surgery

Interventions

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Propofol

Propofol (Random:3-5ug/ml)

Intervention Type DRUG

Low Remifentanil

Remifentanil (Random:0-3ug/ml)

Intervention Type DRUG

Heigh Remifentanil

Remifentanil (Random:3-5ug/ml)

Intervention Type DRUG

Intubation

Endotracheal intubation before surgery

Intervention Type PROCEDURE

tetanic electrical stimulation

tetanic electrical stimulation before surgery

Intervention Type PROCEDURE

Other Intervention Names

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Propofol for tetanic electrical stimulation and intubation Remifentanil for tetanic electrical stimulation Remifentanil for intubation

Eligibility Criteria

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Inclusion Criteria

1. Patients undergoing elective surgery under general anesthesia;
2. Patients with ASA rating I\~III;
3. The age of the patient is more than 18 years old;
4. The informed consent has been signed;

Exclusion Criteria

1. Patients who are participating in other trials;
2. Patients with cognitive impairment, mental illness or taking psychotropic drugs within three months;
3. Patients with a history of stroke;
4. Patients with a history of alcoholism (long-term drinking more than 5 years, daily white wine consumption ≥ 50ml);
5. Pregnant women;
6. Patients with BMI\>30;
7. Patients and family members who are unwilling to participate after understanding the research content;
8. According to the evaluation of the researcher, the actual condition is not suitable for the patients participating in this trial.
Minimum Eligible Age

18 Years

Eligible Sex

ALL

Accepts Healthy Volunteers

No

Sponsors

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Zhang Haopeng

OTHER

Sponsor Role lead

Responsible Party

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Zhang Haopeng

Associate professor

Responsibility Role SPONSOR_INVESTIGATOR

Principal Investigators

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Haopeng Zhang, Dr

Role: PRINCIPAL_INVESTIGATOR

Xijing Hospital

Locations

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Xijing Hospital

Xi'an, Shaanxi, China

Site Status

Countries

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China

References

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Luginbuhl M, Schumacher PM, Vuilleumier P, Vereecke H, Heyse B, Bouillon TW, Struys MM. Noxious stimulation response index: a novel anesthetic state index based on hypnotic-opioid interaction. Anesthesiology. 2010 Apr;112(4):872-80. doi: 10.1097/ALN.0b013e3181d40368.

Reference Type BACKGROUND
PMID: 20216387 (View on PubMed)

Gruenewald M, Ilies C, Herz J, Schoenherr T, Fudickar A, Hocker J, Bein B. Influence of nociceptive stimulation on analgesia nociception index (ANI) during propofol-remifentanil anaesthesia. Br J Anaesth. 2013 Jun;110(6):1024-30. doi: 10.1093/bja/aet019. Epub 2013 Mar 6.

Reference Type BACKGROUND
PMID: 23471754 (View on PubMed)

Schumacher PM, Dossche J, Mortier EP, Luginbuehl M, Bouillon TW, Struys MM. Response surface modeling of the interaction between propofol and sevoflurane. Anesthesiology. 2009 Oct;111(4):790-804. doi: 10.1097/ALN.0b013e3181b799ef.

Reference Type BACKGROUND
PMID: 19741484 (View on PubMed)

Related Links

Other Identifiers

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202302

Identifier Type: -

Identifier Source: org_study_id

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