CAROTID ENDATORECTOMY AND GENERAL ANESTHESIA: Assessment and Evaluation of Cerebral Ischemic Damage With Clinical, Laboratory and Imaging Parameters
CAROTID ENDATORECTOMY AND GENERAL ANESTHESIA: Assessment and Evaluation of Cerebral Ischemic Damage With Clinical, Laboratory and Imaging Parameters: a Single-center, Prospective, Randomized, Comparative Clinical Study
Studieoversigt
Status
Status
Betingelser
Betingelser
Intervention / Behandling
Intervention / Behandling
Detaljeret beskrivelse
Carotid endarterectomy is a surgical procedure with special perioperative and postoperative requirements and potential major adverse events, which can occur rapidly and be life threatening, and compromise the functional and neuropsychiatric integrity of the patient. Stroke is the most frequent major complication both in the intraoperative and immediate postoperative period. The Anesthesiologist is required to ensure adequate cerebral circulation and oxygenation through the close regulation of hemodynamic parameters and the continuous monitoring of cerebral oximetry, with the aim of preventing the occurrence and establishment of cerebral ischemic lesions.
The purpose of this study is to compare two anesthetic drugs (propofol and sevoflurane) during the maintenance of anesthesia in terms of their potential neuroprotective effect, which will be documented through clinical (gross neurological examination and MoCA test), laboratory (neuronal specific enolase NSE and human calcium-binding protein S100B) and imaging (MRI-diffusion) tests, which have proved to have high sensitivity and specificity for the early detection of ischemic brain lesions and cognitive deficits.
Undersøgelsestype
Undersøgelsestype
Tilmelding (Anslået)
Tilmelding
Kontakter og lokationer
Studiekontakt
Studiekontakt
- Navn: ATHANASIA DIMITRIOS VOULGARI, MD
- Telefonnummer: +306979596731
- E-mail: athanasia13494@hotmail.com
Deltagelseskriterier
Berettigelseskriterier
Berettigelseskriterier
Aldre berettiget til at studere
- Voksen
- Ældre voksen
Tager imod sunde frivillige
Prøveudtagningsmetode
Studiebefolkning
Beskrivelse
Inclusion Criteria:
- Age ≥ 18 years
- ASA 1-4
- For planned carotid endarterectomy
- Absence of major established neurological deficits that would not allow neurological evaluation and performance of the MoCA test
- Patient consent to participate in the study
Exclusion Criteria:
- Age ≤ 18 years
- Presence of major neurological deficits that will not allow neurological evaluation and performance of the MoCA test
- Claustrophobia and inability to enter the MRI scanner
- Cochlear implants
- Intracranial vascular clips
- Neurostimulation systems
- Pacemaker incompatible for MRI
- Small cell and non-small cell lung cancer
- Neuroendocrine tumors
- Melanoma
- Seminoma
- Teratoma
- Malignant pheochromocytoma
- CNS or NM diseases
- Schizophrenia
- Allergy or contraindication to any anesthetic factor
- Patient refusal to participate in the study
Studieplan
Hvordan er undersøgelsen tilrettelagt?
Design detaljer
Antal grupper/kohorter
Kohorter og interventioner
Gruppe / kohorteGruppe / kohorte |
Intervention / BehandlingIntervention / Behandling |
|---|---|
|
group propofol
Anesthesia will be preserved using propofol in the patients of this group
|
MRI diffusion and cognitive function assessment tests will be performed prior to surgery and postoperatively 24 hours after the end of the surgery so as any new brain lesion to be detected.
Andre navne:
neuroprotection provided by either sevoflurane or propofol using laboratory, clinical and imaging tests and scores such as alderte score during awakening
Brain biomarkers will be measured prior to artery clampring, 15 minutes after the artery clamping and 15 minutes after the end of surgery
|
|
group sevoflurane
Anesthesia will be preserved using sevoflurane in the patients of this group
|
MRI diffusion and cognitive function assessment tests will be performed prior to surgery and postoperatively 24 hours after the end of the surgery so as any new brain lesion to be detected.
Andre navne:
neuroprotection provided by either sevoflurane or propofol using laboratory, clinical and imaging tests and scores such as alderte score during awakening
Brain biomarkers will be measured prior to artery clampring, 15 minutes after the artery clamping and 15 minutes after the end of surgery
|
Hvad måler undersøgelsen?
Primære resultatmål
Primære resultatmål
Resultatmål |
Foranstaltningsbeskrivelse |
Tidsramme |
|---|---|---|
|
new microischemic brain lesions
Tidsramme: 24 hours preoperative to 24 hours postoperative
|
Number of participants with any silent brain lesions or brain lesions accompanied with cognitive dysfunction postoperatively
|
24 hours preoperative to 24 hours postoperative
|
|
neuroprotective effect
Tidsramme: from 24 hours prior to surgery to 24 hours after the surgery
|
The group of patients that has the fewer adverse events as assessed clinically or with laboratory and imaging tests will be considered to receive the most neuroprotective anesthetic agent
|
from 24 hours prior to surgery to 24 hours after the surgery
|
Samarbejdspartnere og efterforskere
Sponsor
Sponsor
Efterforskere
Efterforskere
- Studiestol: ADAMANTIA ARETHA, PROFESSOR OF ANESTHESIOLOGY, University Hospital of Patras
Datoer for undersøgelser
Studer store datoer
Studiestart (Anslået)
Studiestart
Primær færdiggørelse (Anslået)
Primær færdiggørelse
Studieafslutning (Anslået)
Studieafslutning
Datoer for studieregistrering
Først indsendt
Først indsendt
Først indsendt, der opfyldte QC-kriterier
Først indsendt, der opfyldte QC-kriterier
Først opslået (Faktiske)
Først opslået
Opdateringer af undersøgelsesjournaler
Sidste opdatering sendt (Faktiske)
Sidste opdatering sendt
Sidste opdatering indsendt, der opfyldte kvalitetskontrolkriterier
Sidste opdatering indsendt, der opfyldte kvalitetskontrolkriterier
Sidst verificeret
Sidst verificeret
Mere information
Begreber relateret til denne undersøgelse
Yderligere relevante MeSH-vilkår
- Cerebrovaskulære lidelser
- Hjernesygdomme
- Sygdomme i centralnervesystemet
- Sygdomme i nervesystemet
- Karsygdomme
- Hjerte-kar-sygdomme
- Arterielle okklusive sygdomme
- Slag
- Carotisarteriesygdomme
- Iskæmisk slagtilfælde
- Carotis stenose
- Organiske kemikalier
- Kulbrinter
- Kulbrinter, cyklisk
- Biologiske faktorer
- Folkesundhed
- Miljø og folkesundhed
- Kulbrinter, aromatisk
- Fenoler
- Benzenderivater
- Biologiske fænomener
- Biomarkører
- Miljøforurening
- Miljøovervågning
- Miljøeksponering
- Propofol
- Miljømærkør
Andre undersøgelses-id-numre
Andre undersøgelses-id-numre
- 379/7-10-2025
Plan for individuelle deltagerdata (IPD)
Planlægger du at dele individuelle deltagerdata (IPD)?
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