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- Essai clinique NCT07671781
Processed EEG Monitoring During Controlled Hypotension in Patients Undergoing Rhinoplasty
Observational Evaluation of the Relationship Between Intraoperative Processed EEG Monitoring,Surgical Bleeding and Recovery Quality in Patients Undergoing Rhinoplasty Under Controlled Hypotension
Aperçu de l'étude
Statut
Description détaillée
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.
Type d'étude
Inscription (Réel)
Contacts et emplacements
Lieux d'étude
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Ankara, Turquie (Türkiye)
- Gazi University
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Critères de participation
Critère d'éligibilité
Âges éligibles pour étudier
- Adulte
- Adulte plus âgé
Accepte les volontaires sains
Méthode d'échantillonnage
Population étudiée
La description
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
Plan d'étude
Comment l'étude est-elle conçue ?
Détails de conception
Que mesure l'étude ?
Principaux critères de jugement
Mesure des résultats |
Description de la mesure |
Délai |
|---|---|---|
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Intraoperative qCON and qNOX values during controlled hypotension
Délai: From baseline before anesthesia induction until the end of surgery, up to approximately 150 minutes intraoperatively.
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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.
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From baseline before anesthesia induction until the end of surgery, up to approximately 150 minutes intraoperatively.
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Mesures de résultats secondaires
Mesure des résultats |
Description de la mesure |
Délai |
|---|---|---|
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Heart rate during controlled hypotension
Délai: From baseline before anesthesia induction until the end of surgery, up to approximately 150 minutes intraoperatively.
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Heart rate will be recorded at predefined intraoperative time points to evaluate hemodynamic stability.
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From baseline before anesthesia induction until the end of surgery, up to approximately 150 minutes intraoperatively.
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Autres mesures de résultats
Mesure des résultats |
Description de la mesure |
Délai |
|---|---|---|
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Surgical field bleeding score
Délai: Intraoperatively, from surgical incision until the end of surgery.
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Surgical field bleeding will be evaluated using the Boezaart surgical field bleeding score at predefined intraoperative time points.
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Intraoperatively, from surgical incision until the end of surgery.
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Extubation time
Délai: At the end of surgery
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Time from discontinuation of anesthetic agents to extubation will be recorded in minutes
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At the end of surgery
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Time to reach Aldrete score ≥9
Délai: Early postoperative recovery period, immediately after extubation.
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The time required to reach an Aldrete recovery score of 9 or higher will be recorded in minutes
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Early postoperative recovery period, immediately after extubation.
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Early postoperative delirium assessed by the Nursing Delirium Screening Scale
Délai: At admission to the post-anesthesia care unit
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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.
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At admission to the post-anesthesia care unit
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Total anesthetic drug consumption
Délai: From anesthesia induction until the end of surgery
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Total intraoperative consumption of propofol, remifentanil, and esmolol will be recorded
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From anesthesia induction until the end of surgery
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Collaborateurs et enquêteurs
Parrainer
Les enquêteurs
- Chaise d'étude: Nurdan Bedirli, MD, Gazi University
Publications et liens utiles
Publications générales
- Laferriere-Langlois P, Morisson L, Jeffries S, Duclos C, Espitalier F, Richebe P. Depth of Anesthesia and Nociception Monitoring: Current State and Vision For 2050. Anesth Analg. 2024 Feb 1;138(2):295-307. doi: 10.1213/ANE.0000000000006860. Epub 2024 Jan 12.
- Aldecoa C, Bettelli G, Bilotta F, Sanders RD, Aceto P, Audisio R, Cherubini A, Cunningham C, Dabrowski W, Forookhi A, Gitti N, Immonen K, Kehlet H, Koch S, Kotfis K, Latronico N, MacLullich AMJ, Mevorach L, Mueller A, Neuner B, Piva S, Radtke F, Blaser AR, Renzi S, Romagnoli S, Schubert M, Slooter AJC, Tommasino C, Vasiljewa L, Weiss B, Yuerek F, Spies CD. Update of the European Society of Anaesthesiology and Intensive Care Medicine evidence-based and consensus-based guideline on postoperative delirium in adult patients. Eur J Anaesthesiol. 2024 Feb 1;41(2):81-108. doi: 10.1097/EJA.0000000000001876. Epub 2023 Aug 30.
- Kol IO, Kaygusuz K, Yildirim A, Dogan M, Gursoy S, Yucel E, Mimaroglu C. Controlled hypotension with desflurane combined with esmolol or dexmedetomidine during tympanoplasty in adults: A double-blind, randomized, controlled trial. Curr Ther Res Clin Exp. 2009 Jun;70(3):197-208. doi: 10.1016/j.curtheres.2009.06.001.
Dates d'enregistrement des études
Dates principales de l'étude
Début de l'étude (Réel)
Achèvement primaire (Réel)
Achèvement de l'étude (Réel)
Dates d'inscription aux études
Première soumission
Première soumission répondant aux critères de contrôle qualité
Première publication (Réel)
Mises à jour des dossiers d'étude
Dernière mise à jour publiée (Réel)
Dernière mise à jour soumise répondant aux critères de contrôle qualité
Dernière vérification
Plus d'information
Termes liés à cette étude
Mots clés
Autres numéros d'identification d'étude
- 172
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