Sedline EEG Guided Depth of Anesthesia
SedLine EEG-Guided Depth of Anesthesia: Effect of Anesthetic Dosage
Study Overview
Status
Status
Conditions
Conditions
Intervention / Treatment
Intervention / Treatment
Detailed Description
Study Type
Study Type
Enrollment (Actual)
Enrollment
Phase
Phase
- Not Applicable
Contacts and Locations
Study Contact
Study Contact
- Name: Timothy Webb, MD
- Phone Number: 317-274-0257
- Email: ttwebb@iu.edu
Study Locations
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Indiana
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Indianapolis, Indiana, United States, 46202
- IU Health University Hospital
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-
Participation Criteria
Eligibility Criteria
Eligibility Criteria
Ages Eligible for Study
Accepts Healthy Volunteers
Description
Inclusion Criteria:
- Patients undergoing a scheduled surgery (laparotomy, hepatobiliary surgery, gynecologic surgery, and/or urologic surgery procedures) at Indiana University Health University Hospital that is expected to have at least a 3 day post-operative hospital stay.
- ASA class 1, 2, 3, or 4.
- Age 65 years or older.
- Male or Female
- Surgical procedure requiring general anesthesia.
Exclusion Criteria:
- Any previous diagnosis of dementia or other cognitive impairment.
- Any patient undergoing emergency surgery.
- Any patient undergoing surgery who is currently an inpatient.
- Patient refusal to participate in study.
- Any patient undergoing surgery that would prevent placement of the Sedline monitor leads (for example - surgery on the patient's forehead/scalp).
- Any physical, mental, or medical conditions which, in the opinion of the investigators, may confound the ability to assess the patient for delirium in the post-operative period.
Study Plan
How is the study designed?
Design Details
- Primary Purpose: Other
- Allocation: Randomized
- Interventional Model: Parallel Assignment
- Masking: None (Open Label)
Number of Arms
Arms and Interventions
Participant Group / ArmParticipant Group / Arm |
Intervention / TreatmentIntervention / Treatment |
|---|---|
|
Experimental: Study Group
Prior to the induction of anesthesia, the Sedline monitor will be placed on the patient's head to ensure the monitor is working properly.
For those in the study group, the monitor will be in full view of the anesthesiologist administering the anesthetic.
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EEG monitor (Sedline) will be in full view of the Anesthesiologist during surgery.
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No Intervention: Control Group
Prior to the induction of anesthesia, the Sedline monitor will be placed on the patient's head to ensure the monitor is working properly.
For those in the control group, an apparatus will be placed over the monitor will not be in view of the anesthesiologist.
The
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What is the study measuring?
Primary Outcome Measures
Primary Outcome Measures
Outcome Measure |
Measure Description |
Time Frame |
|---|---|---|
|
Total Average Anesthetic
Time Frame: 5 minutes after induction until the time which administration of neuromuscular blocker reversal drugs is given
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total average percent of volatile anesthetic (sevoflurane) utilized while subjects are under anesthesia (maintenance phase).
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5 minutes after induction until the time which administration of neuromuscular blocker reversal drugs is given
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Secondary Outcome Measures
Secondary Outcome Measures
Outcome Measure |
Measure Description |
Time Frame |
|---|---|---|
|
Total Hypnotic Agents (Midazolam, Ketamine, Methadone, Hydromorphone)
Time Frame: 5 minutes after induction until the time which administration of neuromuscular blocker reversal drugs is given
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the total dosage of hypnotic agents administered while in the maintenance phase of anesthesia.
These agents include: midazolam, methadone, and hydromorphone.
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5 minutes after induction until the time which administration of neuromuscular blocker reversal drugs is given
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Time Period of Hypotension
Time Frame: 5 minutes after induction until the time which administration of neuromuscular blocker reversal drugs is given
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this will be defined as an episode of mean arterial pressure of <65 mmHg
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5 minutes after induction until the time which administration of neuromuscular blocker reversal drugs is given
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|
Total Dosage of Vasopressor (Norepinephrine, Phenylephrine)
Time Frame: 5 minutes after induction until the time which administration of neuromuscular blocker reversal drugs is given
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phenylephrine, norepinephrine
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5 minutes after induction until the time which administration of neuromuscular blocker reversal drugs is given
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Occurrence of EEG Isoelctricity
Time Frame: 5 minutes after induction until administration of neuromuscular blocker reversal drugs up to 24 hours
|
Following the procedure, images and data from the Sedline device were evaluated to determine what percentage of the case a patient's processed EEG displayed isoelectricity (burst suppression).
A burst-suppression (or suppression-burst) pattern is a discontinuous EEG, with periods of marked suppression or isoelectric intervals alternating with "bursts" of activity, with or without embedded epileptiform features (Bauer et al., 2013)
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5 minutes after induction until administration of neuromuscular blocker reversal drugs up to 24 hours
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Total Dosage of Vasopressor (Ephedrine)
Time Frame: 5 minutes after induction until the time which administration of neuromuscular blocker reversal drugs is given
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ephedrine
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5 minutes after induction until the time which administration of neuromuscular blocker reversal drugs is given
|
|
Total Dosage of Vasopressor (Vasopressin)
Time Frame: 5 minutes after induction until the time which administration of neuromuscular blocker reversal drugs is given
|
vasopressin
|
5 minutes after induction until the time which administration of neuromuscular blocker reversal drugs is given
|
|
Total Hypnotic Agents (Fentanyl)
Time Frame: 5 minutes after induction until the time which administration of neuromuscular blocker reversal drugs is given
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the total dosage of hypnotic agents administered while in the maintenance phase of anesthesia; fentanyl.
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5 minutes after induction until the time which administration of neuromuscular blocker reversal drugs is given
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Collaborators and Investigators
Sponsor
Sponsor
Investigators
Investigators
- Principal Investigator: Timothy Webb, MD, Indiana University
Publications and helpful links
General Publications
- Purdon PL, Sampson A, Pavone KJ, Brown EN. Clinical Electroencephalography for Anesthesiologists: Part I: Background and Basic Signatures. Anesthesiology. 2015 Oct;123(4):937-60. doi: 10.1097/ALN.0000000000000841.
- Hajat Z, Ahmad N, Andrzejowski J. The role and limitations of EEG-based depth of anaesthesia monitoring in theatres and intensive care. Anaesthesia. 2017 Jan;72 Suppl 1:38-47. doi: 10.1111/anae.13739.
- MacKenzie KK, Britt-Spells AM, Sands LP, Leung JM. Processed Electroencephalogram Monitoring and Postoperative Delirium: A Systematic Review and Meta-analysis. Anesthesiology. 2018 Sep;129(3):417-427. doi: 10.1097/ALN.0000000000002323.
- Wildes TS, Mickle AM, Ben Abdallah A, Maybrier HR, Oberhaus J, Budelier TP, Kronzer A, McKinnon SL, Park D, Torres BA, Graetz TJ, Emmert DA, Palanca BJ, Goswami S, Jordan K, Lin N, Fritz BA, Stevens TW, Jacobsohn E, Schmitt EM, Inouye SK, Stark S, Lenze EJ, Avidan MS; ENGAGES Research Group. Effect of Electroencephalography-Guided Anesthetic Administration on Postoperative Delirium Among Older Adults Undergoing Major Surgery: The ENGAGES Randomized Clinical Trial. JAMA. 2019 Feb 5;321(5):473-483. doi: 10.1001/jama.2018.22005.
- 4. Kaplan LJ, Bailey H. Bispectral index (BIS) monitoring of ICU patients on continuous infusion of sedatives and paralytics reduces sedative drug utilization and cost.
- Ishizawa Y. Special article: general anesthetic gases and the global environment. Anesth Analg. 2011 Jan;112(1):213-7. doi: 10.1213/ANE.0b013e3181fe02c2. Epub 2010 Nov 3.
Study record dates
Study Major Dates
Study Start (Actual)
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 (Actual)
First Posted
Study Record Updates
Last Update Posted (Estimated)
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
Other Study ID Numbers
Other Study ID Numbers
- 10708 (Other Identifier: CTEP)
Plan for Individual participant data (IPD)
Plan to Share Individual Participant Data (IPD)?
Drug and device information, study documents
Studies a U.S. FDA-regulated drug product
Studies a U.S. FDA-regulated device product
product manufactured in and exported from the U.S.
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