- ICH GCP
- US Clinical Trials Registry
- Clinical Trial NCT05525104
The Effect of DSA on Recovery of Anaesthesia in Children (Het Effect Van DSA op Het Herstel na Anesthesie Bij Kinderen). (DSA-RCT-1)
The Influence of Electroencephalographic Density Spectral Array Guidance of Sevoflurane Administration on Recovery From General Anaesthesia in Children Between 6 Months and 12 Years.
Study Overview
Status
Conditions
Intervention / Treatment
Detailed Description
Electroencephalographic density spectral array (DSA) is a three dimensional method to display electroencephalogram (EEG) signals consisting of the EEG frequency (y-axis), the power of the EEG signal (colour-coded to be integrated into a two dimensional plot) and the development of the EEG power spectrum over time (x-axis). DSA is routinely used to measure depth of hypnosis (DoH) by a part of the staff members in our department. When DSA is used, dose adjustments of sevoflurane will be made based on monitoring depth of anaesthesia. However, most of our colleague do not use DSA. Dose adjustment is then based on (subjective) clinical surrogate parameters, or in general mostly based on a minimal alveolar concentration of the anaesthetic gas that is used.
Electroencephalographic DSA monitoring provides continuous objective information on DoH and should result in a faster speed of emergence and recovery from general anaesthesia (GA). This will be addressed in a randomised controlled trial.
In patients randomised to the intervention group, the anaesthetic agent sevoflurane will be administered on the basis of objective measures of anaesthetic depth, the typical DSA pattern for GA. We expect a significantly faster speed of emergence and recovery in the intervention group based on clinical experience. The Narcotrend monitor is validated for use in paediatric patients. There are thus no additional risk factors apart from those, which are inherent with general anaesthesia. Patient randomised to the control group will receive standard treatment, that is delivery of sevoflurane based on a MAC of 0.9 respectively an end tidal sevoflurane concentration of 2.3%. A non-invasive therapeutical intervention (DSA based conduct of GA) should result in the advantage of faster recovery, without any additional risk factor.
Study Type
Enrollment (Estimated)
Phase
- Not Applicable
Contacts and Locations
Study Contact
- Name: Iris J de Heer, MD
- Phone Number: +31107037881
- Email: i.deheer@erasmusmc.nl
Study Contact Backup
- Name: Hannah AC Raab, BSc
- Email: h.raab@erasmusmc.nl
Study Locations
-
-
Zuid-Holland
-
Rotterdam, Zuid-Holland, Netherlands, 3015GD
- Recruiting
- Erasmus Medical Center
-
Contact:
- Iris J de Heer, MD
- Phone Number: +31107037881
- Email: i.deheer@erasmusmc.nl
-
Contact:
- Frank Weber, MD, PhD
- Phone Number: +31107042521
- Email: f.weber@erasmusmc.nl
-
Sub-Investigator:
- Iris J de Heer, MD
-
Principal Investigator:
- Frank Weber, MD, PhD
-
Sub-Investigator:
- Gülhan Karaöz-Bulut, MSc
-
Sub-Investigator:
- Hannah AC Raab, BSc
-
-
Participation Criteria
Eligibility Criteria
Ages Eligible for Study
Accepts Healthy Volunteers
Description
Inclusion Criteria:
- Written informed consent of parents/guardians
- Age ≥6 months and ≤12 years
- Surgical procedure requiring GA supplemented with caudal analgesia
- Ability of the parents/guardians to communicate in Dutch
Exclusion Criteria:
- Primary exclusion criteria
- Withdrawal of informed consent
- (Chronic) use of drugs influencing the electroencephalogram
- Use of premedication
- Known intolerance for sevoflurane
- Parents/guardians unable to communicate in Dutch
- Secondary exclusion criteria
- Protocol violation
- Data registration failure
Study Plan
How is the study designed?
Design Details
- Primary Purpose: Treatment
- Allocation: Randomized
- Interventional Model: Parallel Assignment
- Masking: Double
Arms and Interventions
Participant Group / Arm |
Intervention / Treatment |
---|---|
No Intervention: Control
In patients randomised to the control group, sevoflurane will be titrated according to a Minimal Alveolar Concentration (MAC) of 0.9 respectively an end tidal sevoflurane concentration of 2.3% based on standard practice in our paediatric anaesthesia department.
|
|
Experimental: Treatment
In patients randomised to the intervention group of the trial, the anaesthetic agent sevoflurane will be titrated according to the typical DSA pattern for general anaesthesia with sevoflurane, provided by the Narcotrend
|
This trial is designed to investigate the additional value of Density Spectral Array monitoring, on the "speed of emergence" after general anaesthesia. We will compare traditional general anaesthesia with sevoflurane using a MAC value and subjective clinical parameters to the objective and continuous approach using DSA depth of hypnosis. The investigational product is the validated Narcotrend monitor, an electroencephalographic monitor, that is regularly used in anaesthesia practice in the Sophia children's hospital and will be used according to intended purpose. The extended version as used in the operating room in the Sophia Children's hospital offers a diversity of diagrams including Density Spectral Array. The electroencephalographic Narcotrend monitor records frontal EEG-activity. Standard paediatric ECG electrodes are used for EEG registration |
What is the study measuring?
Primary Outcome Measures
Outcome Measure |
Measure Description |
Time Frame |
---|---|---|
The influence of DSA monitoring on the speed of emergence.
Time Frame: Day 1
|
The speed of emergence is defined as the time interval between the end of hypnotic drug application and the moment when discharge criteria from the operating room are met (defined as a Steward score ≥ 3)
|
Day 1
|
Secondary Outcome Measures
Outcome Measure |
Measure Description |
Time Frame |
---|---|---|
Total time from discontinuation of anaesthetic drug delivery until discharge from the post anaesthesia care unit.
Time Frame: Day 1
|
The total time is defined as the time interval between the end of hypnotic drug application and the moment when discharge criteria from the recovery room are met (defined as a Steward score =6)
|
Day 1
|
The incidence of postoperative delirium
Time Frame: Day 1
|
The incidence of postoperative delirium is assessed with the Cornell assessment of postoperative delirium (delirium is defined as a score equal to or greater than 9)
|
Day 1
|
Differences of depth of hypnosis during the procedure, as measured by the Narcotrend monitor.
Time Frame: Day 1
|
Density spectral array patterns will be saved, and divided into categories, which will be compared between the two study groups.
|
Day 1
|
Incidence of recall of events during the procedure (awareness)
Time Frame: Day 1, Day 2, Day 14
|
Awareness is assessed with a modified Brice interview in children of 6 years or older.
|
Day 1, Day 2, Day 14
|
Other Outcome Measures
Outcome Measure |
Time Frame |
---|---|
Adverse events
Time Frame: Day 1
|
Day 1
|
Collaborators and Investigators
Sponsor
Investigators
- Principal Investigator: Frank Weber, MD, PhD, Erasmus Medical Center
Study record dates
Study Major Dates
Study Start (Actual)
Primary Completion (Estimated)
Study Completion (Estimated)
Study Registration Dates
First Submitted
First Submitted That Met QC Criteria
First Posted (Actual)
Study Record Updates
Last Update Posted (Actual)
Last Update Submitted That Met QC Criteria
Last Verified
More Information
Terms related to this study
Other Study ID Numbers
- DSA-RCT-1
- NL80282.078.22 (Other Identifier: CCMO)
Plan for Individual participant data (IPD)
Plan to Share Individual Participant Data (IPD)?
IPD Plan Description
On reasonable request to the study coordinator data will be shared.
Data of a patient will only be shared with others if the parents explicitly consented to saving their child's data.
IPD Sharing Time Frame
IPD Sharing Access Criteria
IPD Sharing Supporting Information Type
- STUDY_PROTOCOL
- SAP
- CSR
Drug and device information, study documents
Studies a U.S. FDA-regulated drug product
Studies a U.S. FDA-regulated device product
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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