Inhalational Anesthesia vs TIVA in Endoscopic Tympanoplasty

NCT ID: NCT05993039

Last Updated: 2023-11-01

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

EARLY_PHASE1

Total Enrollment

100 participants

Study Classification

INTERVENTIONAL

Study Start Date

2023-09-01

Study Completion Date

2024-12-31

Brief Summary

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This study aims to prospectively compare surgical field quality and intraoperative blood loss between general inhalational anesthesia to total intravenous anesthesia (TIVA) alone in subjects undergoing endoscopic ear surgery. A secondary objective is to compare rates of emergence delirium and total recovery time between the two groups.

Detailed Description

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In sinus surgery, TIVA has been described as a possible advantage in the use of endoscopic ear surgery. However, to date, there are no studies that examine blood loss, surgical field quality, and recovery in TIVA compared to inhalational anesthesia in the setting of endoscopic ear surgery. The hypothesis is that in patients who undergo endoscopic tympanoplasty, those who receive TIVA will have reduced intraoperative blood loss, improved surgical field quality, and reduced emergence agitation than those who receive inhalational anesthesia. This study will be a prospective double-blinded randomized control trial consisting of subjects undergoing endoscopic tympanoplasty surgery to assess intraoperative blood loss, surgical field quality, rates of emergence delirium, and recovery time.

Conditions

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Perforated Eardrum

Study Design

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Allocation Method

RANDOMIZED

Intervention Model

PARALLEL

double-blinded randomized control
Primary Study Purpose

TREATMENT

Blinding Strategy

DOUBLE

Participants Caregivers
In the operating room, in order to blind the surgeon to the type of anesthesia used, a surgical drape will be placed in between the subject and the anesthesia team to conceal the anesthesia machinery and equipment. A sham intravenous pole will be at the anesthesia workstation for those subjects in the control arm to contribute to the blinding of the surgeon. Patients will not be informed about which arm they are randomly assigned to and only the anesthesiologist will be aware prior to the surgery.

Study Groups

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Inhalational Anesthesia

Adults:

The control group will receive general inhalational anesthesia (sevoflurane, isoflurane). The will be induced with fentanyl 1-2µg/kg, propofol 2mg/kg, lidocaine 1mg/kg. After orotracheal intubation, anesthesia will be maintained with isoflurane 1.5-2% or sevoflurane 1-2%.

Children (12 or younger) induced with a combination of volatile anesthetic gases, including sevoflurane (up to 8%) and nitrous oxide gas (up to 70%). Those who are older than 12 will have an intravenous line placed in the preoperative area and as such will be induced with remifentanil and propofol as above. For maintenance, children in the control arm will receive 0.6 - 1.5% sevoflurane.

Group Type ACTIVE_COMPARATOR

Isoflurane Inhalant Product

Intervention Type DRUG

1.5-2%

Sevoflurane inhalant product

Intervention Type DRUG

1-2% adults 0.6-1.5% Children

Total Intravenous Anesthesia (TIVA)

Adults:

The comparator arm will receive total intravenous anesthesia (propofol and remifentanil). They will be induced with fentanyl 1-2µg/kg, propofol 2mg/kg, and lidocaine 1mg/kg. After orotracheal intubation, anesthesia will be maintained with propofol 100-200mcg/kg/min, remifentanil 0.05-2µg/kg/min.

Children (12 or younger) induced with a combination of volatile anesthetic gases, including sevoflurane (up to 8%) and nitrous oxide gas (up to 70%). Those who are older than 12 will have an intravenous line placed in the preoperative area and as such will be induced with remifentanil and propofol as above. For maintenance, they will receive 100-200mcg/min propofol and 0.05-2µg/kg/min remifentanil.

Group Type ACTIVE_COMPARATOR

Propofol injection

Intervention Type DRUG

1mg/kg-mcg/kg/min adults 100-200mcg/kg/min children

Remifentanil Injection

Intervention Type DRUG

0.05-2ug/kg/min adults and children

Interventions

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Isoflurane Inhalant Product

1.5-2%

Intervention Type DRUG

Sevoflurane inhalant product

1-2% adults 0.6-1.5% Children

Intervention Type DRUG

Propofol injection

1mg/kg-mcg/kg/min adults 100-200mcg/kg/min children

Intervention Type DRUG

Remifentanil Injection

0.05-2ug/kg/min adults and children

Intervention Type DRUG

Eligibility Criteria

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Inclusion Criteria

* Individuals of all ages
* Scheduled to undergo an endoscopic tympanoplasty

Exclusion Criteria

* Individuals with anticoagulation disorders
* Those receiving anticoagulation therapy currently
Minimum Eligible Age

0 Years

Maximum Eligible Age

100 Years

Eligible Sex

ALL

Accepts Healthy Volunteers

No

Sponsors

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Louisiana State University Health Sciences Center in New Orleans

OTHER

Sponsor Role collaborator

Our Lady of the Lake Hospital

OTHER

Sponsor Role lead

Responsible Party

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Leslie Son

Research Scientist-Study Coordinator

Responsibility Role PRINCIPAL_INVESTIGATOR

Principal Investigators

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Rahul Mehta, MD

Role: PRINCIPAL_INVESTIGATOR

Our Lady of the Lake Hospital

Locations

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Our Lady of the Lake Hospital

Baton Rouge, Louisiana, United States

Site Status RECRUITING

Countries

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United States

Central Contacts

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Leslie S Son, PhD

Role: CONTACT

225-765-7659

Christine LeBoeuf, DNP

Role: CONTACT

225-765-7659

Facility Contacts

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Leslie Son, Ph.D.

Role: primary

225-757-4165

Other Identifiers

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TIVA in Ear Surgery

Identifier Type: -

Identifier Source: org_study_id

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