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Processed EEG Monitoring During Controlled Hypotension in Patients Undergoing Rhinoplasty

25. juni 2026 opdateret af: Elif KARAKAYA, Gazi University

Observational Evaluation of the Relationship Between Intraoperative Processed EEG Monitoring,Surgical Bleeding and Recovery Quality in Patients Undergoing Rhinoplasty Under Controlled Hypotension

This prospective observational study evaluates intraoperative processed electroencephalography parameters in adult patients undergoing elective rhinoplasty under total intravenous anesthesia with controlled hypotension. The study focuses on qCON and qNOX values during anesthesia, their relationship with early postoperative recovery, and their association with intraoperative surgical bleeding and surgical field quality.

Studieoversigt

Status

Afsluttet

Betingelser

Detaljeret beskrivelse

Controlled hypotension is commonly used during rhinoplasty to improve surgical field visibility and reduce bleeding. However, the adequacy and safety of controlled hypotension should not be evaluated only by hemodynamic variables. Processed EEG monitoring may provide additional information about hypnotic depth and the probability of response to nociceptive stimulation.

In this prospective observational study, adult patients undergoing elective rhinoplasty under general anesthesia were monitored with standard ASA monitoring and processed EEG monitoring. Total intravenous anesthesia was maintained with propofol and remifentanil. Esmolol infusion was used as part of the controlled hypotension strategy. Intraoperative qCON and qNOX values, hemodynamic parameters, surgical bleeding scores, anesthetic drug consumption, extubation time, time to reach Aldrete score ≥9, and early postoperative cognitive recovery were recorded.

The primary objective is to evaluate the intraoperative course of qCON and qNOX values during controlled hypotension. Secondary objectives are to assess the relationship of processed EEG parameters with recovery quality, early postoperative cognitive status, anesthetic drug consumption, and surgical field bleeding.

Undersøgelsestype

Observationel

Tilmelding (Faktiske)

64

Kontakter og lokationer

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Studiesteder

Deltagelseskriterier

Forskere leder efter personer, der passer til en bestemt beskrivelse, kaldet berettigelseskriterier. Nogle eksempler på disse kriterier er en persons generelle helbredstilstand eller tidligere behandlinger.

Berettigelseskriterier

Aldre berettiget til at studere

  • Voksen
  • Ældre voksen

Tager imod sunde frivillige

Ingen

Prøveudtagningsmetode

Ikke-sandsynlighedsprøve

Studiebefolkning

Adult patients scheduled for elective rhinoplasty under general anesthesia at Gazi University Faculty of Medicine were included in this prospective observational study. All patients underwent total intravenous anesthesia with esmolol-supported controlled hypotension and intraoperative processed EEG monitoring. Hemodynamic parameters, qCON and qNOX values, surgical bleeding scores, anesthetic drug consumption, and early postoperative recovery outcomes were recorded.

Beskrivelse

Inclusion Criteria:

  • Patients aged 18 years or older
  • Patients scheduled for elective rhinoplasty
  • Patients classified as ASA physical status I-II
  • Patients planned to undergo general anesthesia with total intravenous anesthesia
  • Patients in whom frontal processed EEG electrodes can be applied
  • Patients who provide written informed consent

Exclusion Criteria:

  • Emergency surgery
  • Severe neurological disease
  • Scalp lesion or marked dermatitis preventing processed EEG electrode placement
  • Communication or hearing impairment preventing postoperative assessment
  • Marked hemodynamic instability
  • Multiple trauma or need for postoperative intensive care unit admission
  • Pregnancy

Studieplan

Dette afsnit indeholder detaljer om studieplanen, herunder hvordan undersøgelsen er designet, og hvad undersøgelsen måler.

Hvordan er undersøgelsen tilrettelagt?

Design detaljer

Hvad måler undersøgelsen?

Primære resultatmål

Resultatmål
Foranstaltningsbeskrivelse
Tidsramme
Intraoperative qCON and qNOX values during controlled hypotension
Tidsramme: From baseline before anesthesia induction until the end of surgery, up to approximately 150 minutes intraoperatively.
qCON and qNOX values obtained by processed EEG monitoring will be recorded at predefined intraoperative time points. qCON will be used as an index of hypnotic depth, and qNOX will be used as an index of the probability of response to nociceptive stimulation.
From baseline before anesthesia induction until the end of surgery, up to approximately 150 minutes intraoperatively.

Sekundære resultatmål

Resultatmål
Foranstaltningsbeskrivelse
Tidsramme
Heart rate during controlled hypotension
Tidsramme: From baseline before anesthesia induction until the end of surgery, up to approximately 150 minutes intraoperatively.
Heart rate will be recorded at predefined intraoperative time points to evaluate hemodynamic stability.
From baseline before anesthesia induction until the end of surgery, up to approximately 150 minutes intraoperatively.

Andre resultatmål

Resultatmål
Foranstaltningsbeskrivelse
Tidsramme
Surgical field bleeding score
Tidsramme: Intraoperatively, from surgical incision until the end of surgery.
Surgical field bleeding will be evaluated using the Boezaart surgical field bleeding score at predefined intraoperative time points.
Intraoperatively, from surgical incision until the end of surgery.
Extubation time
Tidsramme: At the end of surgery
Time from discontinuation of anesthetic agents to extubation will be recorded in minutes
At the end of surgery
Time to reach Aldrete score ≥9
Tidsramme: Early postoperative recovery period, immediately after extubation.
The time required to reach an Aldrete recovery score of 9 or higher will be recorded in minutes
Early postoperative recovery period, immediately after extubation.
Early postoperative delirium assessed by the Nursing Delirium Screening Scale
Tidsramme: At admission to the post-anesthesia care unit
Patients were assessed for early postoperative delirium in the post-anesthesia care unit using the Nursing Delirium Screening Scale (Nu-DESC). The Nu-DESC ranges from 0 to 10, with higher scores indicating more severe delirium symptoms.
At admission to the post-anesthesia care unit
Total anesthetic drug consumption
Tidsramme: From anesthesia induction until the end of surgery
Total intraoperative consumption of propofol, remifentanil, and esmolol will be recorded
From anesthesia induction until the end of surgery

Samarbejdspartnere og efterforskere

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Sponsor

Efterforskere

  • Studiestol: Nurdan Bedirli, MD, Gazi University

Publikationer og nyttige links

Den person, der er ansvarlig for at indtaste oplysninger om undersøgelsen, leverer frivilligt disse publikationer. Disse kan handle om alt relateret til undersøgelsen.

Datoer for undersøgelser

Disse datoer sporer fremskridtene for indsendelser af undersøgelsesrekord og resumeresultater til ClinicalTrials.gov. Studieregistreringer og rapporterede resultater gennemgås af National Library of Medicine (NLM) for at sikre, at de opfylder specifikke kvalitetskontrolstandarder, før de offentliggøres på den offentlige hjemmeside.

Studer store datoer

Studiestart (Faktiske)

1. november 2025

Primær færdiggørelse (Faktiske)

25. februar 2026

Studieafslutning (Faktiske)

25. februar 2026

Datoer for studieregistrering

Først indsendt

20. juni 2026

Først indsendt, der opfyldte QC-kriterier

25. juni 2026

Først opslået (Faktiske)

26. juni 2026

Opdateringer af undersøgelsesjournaler

Sidste opdatering sendt (Faktiske)

26. juni 2026

Sidste opdatering indsendt, der opfyldte kvalitetskontrolkriterier

25. juni 2026

Sidst verificeret

1. februar 2026

Mere information

Begreber relateret til denne undersøgelse

Andre undersøgelses-id-numre

  • 172

Plan for individuelle deltagerdata (IPD)

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INGEN

IPD-planbeskrivelse

Individual participant data will not be shared due to institutional and ethical restrictions and to protect participant confidentiality.

Lægemiddel- og udstyrsoplysninger, undersøgelsesdokumenter

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