Dexmedetomidine Reduces Sevoflurane MAC-BAR During Pneumoperitoneum

NCT ID: NCT06575179

Last Updated: 2024-10-01

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

RECRUITING

Clinical Phase

PHASE4

Total Enrollment

90 participants

Study Classification

INTERVENTIONAL

Study Start Date

2024-09-02

Study Completion Date

2024-12-30

Brief Summary

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This clinical trial aims to learn the impact of dexmedetomidine on the minimum alveolar concentration blunting the adrenergic response (MAC-BAR) of sevoflurane to carbon dioxide pneumoperitoneum in patients undergoing laparoscopic cholecystectomy. It will also learn about the effect of dexmedetomidine on hemodynamic parameters. The main questions are:

* Does dexmedetomidine reduce the MAC-BAR of sevoflurane required to suppress the sympathetic response to carbon dioxide pneumoperitoneum?
* Would dexmedetomidine administration dose-dependently reduce the minimum alveolar concentration blunting the adrenergic response of sevoflurane required to suppress the sympathetic response to carbon dioxide pneumoperitoneum? Researchers will compare low-dose dexmedetomidine to high-dose dexmedetomidine to see if dexmedetomidine works to treat postoperative negative behavior change and emergence delirium.

Participants will:

* Take intravenous dexmedetomidine or 0.9% saline (a look-alike substance that contains no drug)
* Study drug infusions were initiated 15 minutes prior to anesthesia induction, allowing a minimum of 30 minutes to elapse before surgical incision to achieve steady-state plasma and brain concentrations.

Detailed Description

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Laparoscopic (minimally invasive) surgery has several advantages over open surgery, including less tissue damage, faster recovery, and fewer complications. This has led to widespread use of laparoscopic techniques. However, the inflated carbon dioxide gas used to create the surgical space during laparoscopic surgery causes significant changes in the body's normal blood pressure and heart function.

The anesthetic drug sevoflurane is commonly used during these procedures, but higher doses are needed to adequately block the body's stress response to the inflated gas. The minimum alveolar concentration blunting the adrenergic response (MAC-BAR) measures the minimum anesthetic depth required to suppress the sympathetic/stress response in 50% of patients. Doctors use MAC-BAR values to help determine the appropriate anesthetic dose to maintain hemodynamic stability. Unfortunately, using higher sevoflurane doses to reach the necessary MAC-BAR increases the risk of low blood pressure, reduced heart function, and confusion after surgery.

The drug dexmedetomidine has properties that can help manage the body's stress response during surgery. Researchers wanted to see if dexmedetomidine could allow the use of lower, more stable doses of sevoflurane during laparoscopic procedures by reducing the body's reaction to the inflated gas.

The goal of this study was to evaluate how dexmedetomidine affects the MAC-BAR of sevoflurane needed to block the sympathetic/stress response to the inflated gas used in laparoscopic surgery.

Conditions

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Laparoscopic Cholecystectomy

Study Design

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Allocation Method

RANDOMIZED

Intervention Model

PARALLEL

Primary Study Purpose

PREVENTION

Blinding Strategy

QUADRUPLE

Participants Caregivers Investigators Outcome Assessors

Study Groups

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Control group

The control group received volume-matched 0.9% saline infusions at identical rates.

Group Type PLACEBO_COMPARATOR

normal Saline

Intervention Type DRUG

The control group received volume-matched 0.9% saline infusions at identical rates.

Low-dose dexmedetomidine group

The low-dose dexmedetomidine group received a 75 μg/h loading dose over 15 minutes, followed by 60 μg/h maintenance infusion intravenously.

Group Type EXPERIMENTAL

Dexmedetomidine low-dose

Intervention Type DRUG

The low-dose dexmedetomidine group received a 75 μg/h loading dose over 15 minutes, followed by 60 μg/h maintenance infusion intravenously.

High-dose dexmedetomidine group

The high-dose dexmedetomidine group received a 150 μg/h loading dose over 15 minutes, followed by 120 μg/h maintenance infusion intravenously.

Group Type EXPERIMENTAL

Dexmedetomidine high-dose

Intervention Type DRUG

The high-dose dexmedetomidine group received a 150 μg/h loading dose over 15 minutes, followed by 120 μg/h maintenance infusion intravenously.

Interventions

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Dexmedetomidine low-dose

The low-dose dexmedetomidine group received a 75 μg/h loading dose over 15 minutes, followed by 60 μg/h maintenance infusion intravenously.

Intervention Type DRUG

normal Saline

The control group received volume-matched 0.9% saline infusions at identical rates.

Intervention Type DRUG

Dexmedetomidine high-dose

The high-dose dexmedetomidine group received a 150 μg/h loading dose over 15 minutes, followed by 120 μg/h maintenance infusion intravenously.

Intervention Type DRUG

Other Intervention Names

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dexmedetomidine hydrochloride Injection dexmedetomidine hydrochloride Injection

Eligibility Criteria

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Inclusion Criteria

* 1\. Aged 18-45 years.
* 2\. American Society of Anesthesiologists (ASA) grade I - II.
* 3\. Patients undergoing elective laparoscopic cholecystectomy.

Exclusion Criteria

* 1\. Inability to provide informed consent;
* 2\. History of chronic pain or substance abuse;
* 3\. Pregnancy;
* 4\. Body mass index (BMI) ≥ 30 kg/m2;
* 5\. Known allergies to the study medications;
* 6\. Intake of medications within the last 72 hours that potential interfere with the determination of the MAC-BAR;
* 7\. Any other condition deemed exclusionary by the investigators.
Minimum Eligible Age

18 Years

Maximum Eligible Age

45 Years

Eligible Sex

ALL

Accepts Healthy Volunteers

No

Sponsors

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Fujian Provincial Hospital

OTHER

Sponsor Role lead

Responsible Party

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Yao Yusheng

Professor

Responsibility Role PRINCIPAL_INVESTIGATOR

Principal Investigators

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Xiaochun Zheng, MD&PhD

Role: STUDY_CHAIR

Fujian Provincial Hospital

Locations

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Fujian Provincial Hospital

Fuzhou, Fujian, China

Site Status RECRUITING

Countries

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China

Central Contacts

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Yusheng Yao, MD&PhD

Role: CONTACT

13559939629

Sisi Chen, MD

Role: CONTACT

15080109541

Facility Contacts

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Yusheng Yao, Doctor

Role: primary

Other Identifiers

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k2022-12-004

Identifier Type: -

Identifier Source: org_study_id

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