- ICH GCP
- US Clinical Trials Registry
- Clinical Trial NCT04058106
Water Homeostasis in Propofol Based Total Intravenous Anesthesia
July 14, 2021 updated by: Myoung Hwa Kim, Gangnam Severance Hospital
The Effect of Propofol Based Total Intravenous Anesthesia for Neuromonitoring on the Intraoperative Water Homeostasis in in Spine Surgery
Previous study reported that propofol binded to glutamate receptors in the hypothalamus and inhibits AVP release mediated by endogenous γ-aminobutyric acid, as well as directly inhibits the regulated calcium currents leading to normal neuronal depolarization and AVP release.
However, there is no clinical data demonstrating the mechanism of propofol can induce transient DI by inhibiting the release of AVP from the hypothalamus when applied to humans.
Remifentanil, binding to the μ-receptor or partly κ-receptor, have been used in total intravenous anesthesia combined with propofol, also reported inhibiting AVP relaese in both the hypothalamus (κ receptor mediator mechanism) and posterior pituitary (μ receptor mediator mechanism).
However, the effects of anesthetics on water homeostasis during surgery have been not well established.
Therefore, we aim to investigate the changes of intraoperative water homeostasis, and related hormones and osmolality in patients with propofol based total intravenous anesthesia due to neuromonitoring for spine surgery.
Study Overview
Status
Withdrawn
Conditions
Intervention / Treatment
Detailed Description
"All patients will get the total intravenous anesthesia with propofol-remifentanil via an effective site-controlled infusion (TCI).
For this, TCI continuous infusion pump will be used with Schnider pharmacokinetic model for propofol and Minto pharmacokinetic model for remifentanil.
Propofol and remifentanil will be initiated with target effective site concentrations of 3 μg.ml-1
and 3 ng.ml-1,
respectively, and controll these concentrations considering patient's consciousness loss and vital signs.
And then 0.6 mg kg-1 rocuronium for muscle relaxation will be administered for intubation.
Anesthesia will be maintained with BIS level 40-60 and vital signs will not be more than 20% of the baseline or less.
In order to prevent the sudden movement of the patient during surgery, rocuronium will be infused continuously about 50% of TOF until the end of intraoperative neuromonitoring.
Study Type
Observational
Contacts and Locations
This section provides the contact details for those conducting the study, and information on where this study is being conducted.
Study Locations
-
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Seoul, Korea, Republic of, 06273
- Myoung Hwa Kim
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Participation Criteria
Researchers look for people who fit a certain description, called eligibility criteria. Some examples of these criteria are a person's general health condition or prior treatments.
Eligibility Criteria
Ages Eligible for Study
20 years to 70 years (Adult, Older Adult)
Accepts Healthy Volunteers
N/A
Genders Eligible for Study
All
Sampling Method
Non-Probability Sample
Study Population
Patients who undergo spine surgery with neuromonitoring
Description
Inclusion Criteria:
- Patients, ASA Classification I-Ⅲ between 20 and 70 years, scheduled the neuromonitoring for spine surgery in department of neurosurgery
Exclusion Criteria:
Taking thiazide/ACEi /ARB for hypertension
- Receiving insulin treatment due to diabetes mellitus
- Diagnosed with kidney disease or GFR < 60
- Diagnosed with liver disease or AST/ALT > 100
- Receiving furosemide or mannitol before surgery
- DI was diagnosed before surgery or having polyuria
- Taking lithium or antibiotics that are known to cause DI
- Do not understand Korean language
- Vulnerable subjects who are unable to obtain consent forms
Study Plan
This section provides details of the study plan, including how the study is designed and what the study is measuring.
How is the study designed?
Design Details
- Observational Models: Case-Only
- Time Perspectives: Prospective
Cohorts and Interventions
Group / Cohort |
Intervention / Treatment |
---|---|
A patient who need the spine surgery
A patient who go the propofol based total intravenous anesthesia due to intraoperative neuromonitorung for spine surgery
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A patient who go the propofol based total intravenous anesthesia due to intraoperative neuromonitorung for unruptured cerebral artery aneurysm clipping surgery
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What is the study measuring?
Primary Outcome Measures
Outcome Measure |
Measure Description |
Time Frame |
---|---|---|
The water homeostasis changes of patients during propofol based total intravenous anesthesia for neuromonitoring in spine surgery
Time Frame: The change over time during surgery: baseline (before operation, T1), one hour after operation (T2), two hours after operation (T3), and three hours after operation (T4) - measure at four times
|
The amount of urine (polyuria standard> 5 ml/kg/h) during surgery
|
The change over time during surgery: baseline (before operation, T1), one hour after operation (T2), two hours after operation (T3), and three hours after operation (T4) - measure at four times
|
Secondary Outcome Measures
Outcome Measure |
Measure Description |
Time Frame |
---|---|---|
Postoperative polyuria (or diabetes insipidus)
Time Frame: At postoperative 24 hours and 48 hours
|
Incidence of postoperative polyuria (or diabetes insipidus)
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At postoperative 24 hours and 48 hours
|
Collaborators and Investigators
This is where you will find people and organizations involved with this study.
Sponsor
Study record dates
These dates track the progress of study record and summary results submissions to ClinicalTrials.gov. Study records and reported results are reviewed by the National Library of Medicine (NLM) to make sure they meet specific quality control standards before being posted on the public website.
Study Major Dates
Study Start (Actual)
August 19, 2019
Primary Completion (Anticipated)
June 30, 2021
Study Completion (Anticipated)
July 15, 2021
Study Registration Dates
First Submitted
July 23, 2019
First Submitted That Met QC Criteria
August 13, 2019
First Posted (Actual)
August 15, 2019
Study Record Updates
Last Update Posted (Actual)
July 20, 2021
Last Update Submitted That Met QC Criteria
July 14, 2021
Last Verified
July 1, 2021
More Information
Terms related to this study
Other Study ID Numbers
- 3-2019-0142
Drug and device information, study documents
Studies a U.S. FDA-regulated drug product
No
Studies a U.S. FDA-regulated device product
No
This information was retrieved directly from the website clinicaltrials.gov without any changes. If you have any requests to change, remove or update your study details, please contact register@clinicaltrials.gov. As soon as a change is implemented on clinicaltrials.gov, this will be updated automatically on our website as well.
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