Optimization of Desflurane in Elderly Patients
Optimization of Desflurane in Elderly Patients Compared With Sevoflurane: A Pilot Study
Various issues had been pointed out when undergoing the anesthesia for elderly patients with sevoflurane, such as delayed emergence, post-operative trouble with swallowing.
Desflurane, which has a lower blood/gas partition coefficient, is expected to contribute the better emergence, along with the recent progress on optimization of delivered amount of anesthesia.
The purpose of this study is to compare the time to emergence in long elderly patient cases with desflurane or sevoflurane, with the recently developed drug-delivery optimization system "Aisys®" (GE Healthcare Japan).
Study Overview
Status
Status
Conditions
Conditions
Intervention / Treatment
Intervention / Treatment
Detailed Description
The objectives of this study is to compare the time to emergence and quality of recovery in long elderly patient cases with desflurane or sevoflurane, with the recently developed drug-delivery optimization system "Aisys®" (GE Healthcare Japan).
Inclusion Criteria:
- Elderly patients (>= 65 yr-old), long operation (> 4hours), abdominal surgery patients
Exclusion Criteria:
- Liver dysfunction, Renal dysfunction, preoperative dementia Neurosurgery patients, Cardiac surgery patients, obese patients(BMI>35)
Study Type
Study Type
Enrollment (Actual)
Enrollment
Phase
Phase
- Phase 2
- Phase 1
Contacts and Locations
Study Locations
-
-
Hokkaido
-
Sappro, Hokkaido, Japan, 0608556
- Sapporo Medical University, School of Medicine
-
-
Participation Criteria
Eligibility Criteria
Eligibility Criteria
Ages Eligible for Study
Accepts Healthy Volunteers
Genders Eligible for Study
Description
Inclusion Criteria:
- Elderly patients (>= 65 yr-old), long operation (> 4hours), abdominal surgery patients
Exclusion Criteria:
- Liver dysfunction, Renal dysfunction, preoperative dementia Neurosurgery patients, Cardiac surgery patients, obese patients(BMI>35)
Study Plan
How is the study designed?
Design Details
- Primary Purpose: Treatment
- Allocation: Randomized
- Interventional Model: Parallel Assignment
- Masking: Single
Number of Arms
Arms and Interventions
Participant Group / ArmParticipant Group / Arm |
Intervention / TreatmentIntervention / Treatment |
|---|---|
|
Active Comparator: group DES
The patients in this arm will be given the general anesthesia with desflurane and be used the Aysis as the anesthetic machine.
|
The patients in this arm will be given the general anesthesia with desflurane and be used the Aysis as the anesthetic machine.
Other Names:
|
|
Active Comparator: group SEVO
The patients in this arm will be given the general anesthesia with sevoflurane and be used the Aysis as the anesthetic machine.
|
The patients in this arm will be given the general anesthesia with sevoflurane and be used the Aysis as the anesthetic machine.
Other Names:
|
What is the study measuring?
Primary Outcome Measures
Primary Outcome Measures
Outcome Measure |
Measure Description |
Time Frame |
|---|---|---|
|
The Time From the End of Anesthesia to Extubation
Time Frame: Within 60 minutes after the end of anesthesia
|
When surgery ends, the fresh gas flow rate will be increased to 6L/min (100% oxygen).
Patients will be asked to open eyes by touching the shoulder, calling the name every 15 seconds.
Patients will be applied stimulus every 15 seconds until following commands.
Extubation will be performed when the patient is judged to be awake and spontaneous breathing recovery substantially.
|
Within 60 minutes after the end of anesthesia
|
Secondary Outcome Measures
Secondary Outcome Measures
Outcome Measure |
Measure Description |
Time Frame |
|---|---|---|
|
The Time From the End of Anesthesia to Eye Opening
Time Frame: Within 60 minutes after the end of anesthesia
|
When surgery ends, the fresh gas flow rate will be increased to 6L/min (100% oxygen).
Patients will be asked to open eyes by touching the shoulder, calling the name every 15 seconds.
Patients will be applied stimulus every 15 seconds until following commands.
Extubation will be performed when the patient is judged to be awake and spontaneous breathing recovery substantially.
|
Within 60 minutes after the end of anesthesia
|
|
The Time From the End of Anesthesia to Following Commands
Time Frame: Within 60 minutes after the end of anesthesia
|
When surgery ends, the fresh gas flow rate will be increased to 6L/min (100% oxygen).
Patients will be asked to open eyes by touching the shoulder, calling the name every 15 seconds.
Patients will be applied stimulus every 15 seconds until following commands.
Extubation will be performed when the patient is judged to be awake and spontaneous breathing recovery substantially.
|
Within 60 minutes after the end of anesthesia
|
|
Cognitive Function
Time Frame: 24 hrs pre and postoperatively
|
Cognitive function will be measured by MMSE (Mini-Mental State Examination) at 24hrs pre and postoperatively.
Total MMSE score is recorded by interview ranging from 0 (minimum) to 30 (maximum).
MMSE score is consisted on 11 subscales, and total MMSE score is simply summation of all the subscale scores.
Maximum MMSE score indicates that the patient is excellent for cognitive function.
MMSE score under 26 indicated the cognitive dysfunction.
|
24 hrs pre and postoperatively
|
|
The Incidence of Postoperative Delirium
Time Frame: from 15 minutes to 48 hrs postoperatively
|
The incidence of post operative delirium will be measured by Confusion Assessment Method (CAM) at baseline, 15mins, 3hrs, 6hrs, 12hrs, 24hrs, 48hrs postoperatively.
|
from 15 minutes to 48 hrs postoperatively
|
Collaborators and Investigators
Sponsor
Sponsor
Investigators
Investigators
- Principal Investigator: Michiaki Yamakage, M.D.,PhD, Sapporo Medical University, School of Medicine
Study record dates
Study Major Dates
Study Start
Study Start
Primary Completion (Actual)
Primary Completion
Study Completion (Actual)
Study Completion
Study Registration Dates
First Submitted
First Submitted
First Submitted That Met QC Criteria
First Submitted That Met QC Criteria
First Posted (Estimate)
First Posted
Study Record Updates
Last Update Posted (Estimate)
Last Update Posted
Last Update Submitted That Met QC Criteria
Last Update Submitted That Met QC Criteria
Last Verified
Last Verified
More Information
Terms related to this study
Additional Relevant MeSH Terms
- Mental Disorders
- Pathologic Processes
- Postoperative Complications
- Neurocognitive Disorders
- Cognition Disorders
- Cognitive Dysfunction
- Postoperative Cognitive Complications
- Physiological Effects of Drugs
- Central Nervous System Depressants
- Anesthetics, General
- Anesthetics
- Platelet Aggregation Inhibitors
- Anesthetics, Inhalation
- Desflurane
- Sevoflurane
Other Study ID Numbers
Other Study ID Numbers
- DES-40-POCD
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