Hypotensive Anesthesia for Orthognathic Surgery

NCT ID: NCT06093893

Last Updated: 2025-12-30

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

RECRUITING

Clinical Phase

PHASE4

Total Enrollment

90 participants

Study Classification

INTERVENTIONAL

Study Start Date

2025-03-04

Study Completion Date

2026-03-31

Brief Summary

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The overall objective of this double blinded, randomized controlled trial (RCT) is to compare specific outcomes of three medications (Dexmedetomidine, Nicardipine, and Labetalol) which are routinely used to lower blood pressure used during general anesthesia for orthognathic (jaw) surgery. The outcome measures for the study will be surgical field visibility, estimated blood loss, hemodynamic parameters, operation time, and adverse events.

The specific objectives of this study are to compare:

1. Dexmedetomidine, Nicardipine, and Labetalol's effect on the quality of the surgical field. (Primary Outcome)
2. Dexmedetomidine, Nicardipine, and Labetalol's effect on estimated blood loss.
3. Dexmedetomidine, Nicardipine, and Labetalol's effect on hemodynamic parameters including systolic blood pressure, mean arterial pressure, and heart rate.
4. Dexmedetomidine, Nicardipine, and Labetalol's effect on operation time.
5. Dexmedetomidine, Nicardipine, and Labetalol's effect on adverse events.

The investigators will evaluate healthy adult male and female patients who require jaw surgery at Boston Medical Center. The anticipated 90 participants will be randomized into three groups: ) A Labetalol group in which the patients receive hypotensive anesthesia with the aid of labetalol, 2) A Nicardipine group in which the patients receive hypotensive anesthesia with the aid of nicardipine, and 3) A Dexmedetomidine group in which the patients receive hypotensive anesthesia with the aid of dexmedetomidine.

The time it will take for each individual participant ranges from 1-3 months. This time includes the pre-operative visit, the surgical procedure, a 1-week post-operation visit, and then followed for 30 days post-operatively after which the patient's participation in the study will conclude.

Detailed Description

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Conditions

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Hypotensive Anesthesia Orthognathic Surgery

Keywords

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Dexmedetomidine Nicardipine Labetalol Surgeon visibility Blood loss Hemodynamic parameters Operation time

Study Design

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Allocation Method

RANDOMIZED

Intervention Model

PARALLEL

Primary Study Purpose

TREATMENT

Blinding Strategy

DOUBLE

Participants Investigators

Study Groups

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Dexmedetomidine group

Participants randomized into this group will be given Dexmedetomidine to lower their blood pressure during jaw surgery.

Group Type EXPERIMENTAL

Dexmedetomidine

Intervention Type DRUG

1 mcg/kg will be administered intravenously over 10 minutes; followed by maintenance infusion of 0.2 to 1 mcg/kg/hour.

Nicardipine group

Participants randomized into this group will be given Nicardipine to lower their blood pressure during jaw surgery.

Group Type EXPERIMENTAL

Nicardipine

Intervention Type DRUG

1 mg will be administered intravenously and increase by 0.5-1 mg if the initial dose is ineffective, to a maximum of 15 mg / hour or

Labetalol group

Participants randomized into this group will be given Labetalol to lower their blood pressure during jaw surgery.

Group Type EXPERIMENTAL

Labetalol

Intervention Type DRUG

20 - 80 mg will be administered intravenously at 10-minute intervals to maximum of 300 mg;

Interventions

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Dexmedetomidine

1 mcg/kg will be administered intravenously over 10 minutes; followed by maintenance infusion of 0.2 to 1 mcg/kg/hour.

Intervention Type DRUG

Nicardipine

1 mg will be administered intravenously and increase by 0.5-1 mg if the initial dose is ineffective, to a maximum of 15 mg / hour or

Intervention Type DRUG

Labetalol

20 - 80 mg will be administered intravenously at 10-minute intervals to maximum of 300 mg;

Intervention Type DRUG

Other Intervention Names

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Precedex Cardene Labetalol hydrochloride injection

Eligibility Criteria

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Inclusion Criteria

* Adult patients undergoing orthognathic surgery \[Le Fort I, Surgically Assisted Rapid Palatal Expansion (SARPE), Bilateral Sagittal Split Osteotomy (BSSO), or a combination these surgeries\] at Boston Medical Center with Dr. Mehra
* Healthy, American Society of Anesthesiologists (ASA) physical status classification system I or II

Exclusion Criteria

* Patients on a home beta blocker
* Patients on home calcium channel blocker
* Patients on home alpha 2 agonists
* Patients with an allergy to one or more of the intervention medications
* Does not speak English
* Pregnant patients (this is assessed day of surgery per standard care with a urine pregnancy test)
* Patients who have contraindications to induced hypotensive anesthesia
Minimum Eligible Age

18 Years

Eligible Sex

ALL

Accepts Healthy Volunteers

No

Sponsors

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Boston Medical Center

OTHER

Sponsor Role lead

Responsible Party

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Responsibility Role SPONSOR

Principal Investigators

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Pushkar Mehra, DMD

Role: PRINCIPAL_INVESTIGATOR

Oral and Maxillofacial Surgery Department, Boston Medical Center

Locations

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Boston Medical Center

Boston, Massachusetts, United States

Site Status RECRUITING

Countries

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United States

Central Contacts

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Pushkar Mehra, DMD

Role: CONTACT

Phone: 617-638-4350

Email: [email protected]

Madison Courtney, DDS

Role: CONTACT

Phone: 617-638-4350

Email: [email protected]

Facility Contacts

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Madison Courtney, DDS

Role: primary

Other Identifiers

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H-43663

Identifier Type: -

Identifier Source: org_study_id