Sevoflurane vs Propofol Anesthesia in Obese Patients Undergoing Lumbar Surgery
Comparison of the Immunomodulatory Effects of Sevoflurane and Propofol Anesthesia on Pentraxin-3 and Serum Amyloid A Levels in Obese Patients Undergoing Lumbar Instrumentation Surgery
調査の概要
状態
状態
条件
条件
介入・治療
介入・治療
詳細な説明
Obesity is associated with chronic low-grade inflammation and altered immune responses, which may influence perioperative outcomes. Different anesthetic techniques may modulate inflammatory and immunological pathways during the perioperative period. However, the comparative immunomodulatory effects of inhalational and intravenous anesthetic techniques in obese patients undergoing lumbar instrumentation surgery remain insufficiently investigated.
This prospective, randomized, single-center, single-masked clinical trial is designed to evaluate the effects of sevoflurane-based inhalational anesthesia and propofol-based total intravenous anesthesia on perioperative inflammatory biomarkers in obese patients undergoing elective lumbar instrumentation surgery.
A total of 70 patients aged 18-65 years with a body mass index between 30 and 34.9 kg/m² will be enrolled and randomized in a 1:1 ratio into two study groups. In both groups, anesthesia induction will be standardized using propofol, remifentanil, and rocuronium. Maintenance anesthesia will be performed with either sevoflurane inhalation or propofol infusion in combination with remifentanil infusion under BIS monitoring.
Blood samples will be collected at three different time points: preoperatively, postoperative 6th hour, and postoperative 24th hour. Pentraxin-3 and serum amyloid A levels will be evaluated as the primary inflammatory biomarkers. Secondary laboratory parameters will include IL-6, TNF-α, CRP, glucose, and complete blood count values.
The findings of this study may contribute to understanding the immunomodulatory effects of commonly used anesthetic techniques and may help optimize perioperative anesthetic management in obese patients undergoing spinal surgery.
研究の種類
研究の種類
入学 (推定)
入学
段階
段階
- 適用できない
連絡先と場所
研究連絡先
研究連絡先
- 名前:Ayşe Ceren Hilal Güven, assistant doctor
- 電話番号:554-112-25-81
- メール:achg1995@gmail.com
研究連絡先のバックアップ
- 名前:Mehmet Akif Yilmaz, Doctor
- 電話番号:+905346533539
- メール:mehmetakifyilmaz025@gmail.com
研究場所
-
-
-
Erzurum、トルコ(Türkiye)、25000
- 募集
- Ataturk University
-
コンタクト:
- Ayşe Ceren Hilal Güven, assistant doctor
- 電話番号:554-112-25-81
- メール:achg1995@gmail.com
-
-
参加基準
適格基準
適格基準
就学可能な年齢
- 大人
- 高齢者
健康ボランティアの受け入れ
説明
Inclusion Criteria:
- Patients aged between 18 and 65 years
- Patients scheduled for elective lumbar instrumentation surgery
- Body mass index between 30 and 34.9 kg/m²
- Patients who provided written informed consent
Exclusion Criteria:
- Known allergy to inhalational or intravenous anesthetic agents
- Acute or chronic infectious disease
- Autoimmune disease or immunodeficiency
- Surgery within the last 3 months
- Chronic anti-inflammatory or immunomodulatory drug use
- Morbid obesity, defined as BMI >35 kg/m²
- History of malignancy or active cancer treatment
- Renal failure, defined as GFR <60 mL/min
- Liver failure, defined as AST or ALT greater than 2 times the upper limit of normal
- Diabetes mellitus, metabolic syndrome, or insulin resistance
- Pregnancy or lactation
- Neurological disease, including epilepsy, multiple sclerosis, or Parkinson's disease
- Alcohol or substance abuse
- Inability to comply with the study protocol or provide informed consent
- Known allergy to study drugs (propofol, sevoflurane, remifentanil)
- Emergency surgery
研究計画
研究はどのように設計されていますか?
デザインの詳細
- 主な目的:基礎科学
- 割り当て:ランダム化
- 介入モデル:並列代入
- マスキング:独身
アーム数
武器と介入
参加者グループ / アーム参加者グループ / アーム |
介入・治療介入・治療 |
|---|---|
|
実験的:Propofol Group
Patients in this group will receive propofol-based total intravenous anesthesia (TIVA) during elective lumbar instrumentation surgery.
Anesthesia will be maintained with propofol infusion (4-10 mg/kg/h) combined with remifentanil infusion under BIS monitoring.
|
Propofol-based total intravenous anesthesia (TIVA) administered via continuous infusion (4-10 mg/kg/h) in combination with remifentanil for maintenance of anesthesia under BIS monitoring during elective lumbar instrumentation surgery.
|
|
実験的:Sevoflurane Group
Patients in this group will receive sevoflurane-based inhalational anesthesia during elective lumbar instrumentation surgery.
Anesthesia will be maintained with sevoflurane (1-1.3
MAC) combined with remifentanil infusion under BIS monitoring.
|
Sevoflurane-based inhalational anesthesia administered at 1-1.3 MAC in combination with remifentanil infusion for maintenance of anesthesia under BIS monitoring during elective lumbar instrumentation surgery.
|
この研究は何を測定していますか?
主要な結果の測定
主要な結果の測定
結果測定 |
メジャーの説明 |
時間枠 |
|---|---|---|
|
Change in Pentraxin 3 Level
時間枠:Baseline, postoperative 6 hours, and postoperative 24 hours
|
Pentraxin 3 level was measured from blood samples to evaluate the immunomodulatory effects of propofol- and sevoflurane-based anesthesia.
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Baseline, postoperative 6 hours, and postoperative 24 hours
|
|
Change in Serum Amyloid A Level
時間枠:Baseline, postoperative 6 hours, and postoperative 24 hours
|
Serum amyloid A level was measured from blood samples to evaluate the inflammatory response after surgery.
|
Baseline, postoperative 6 hours, and postoperative 24 hours
|
二次結果の測定
二次結果の測定
結果測定 |
メジャーの説明 |
時間枠 |
|---|---|---|
|
Change in Interleukin-6 Level
時間枠:Baseline, postoperative 6 hours, and postoperative 24 hours
|
Interleukin-6 level was measured from blood samples as an inflammatory biomarker.
|
Baseline, postoperative 6 hours, and postoperative 24 hours
|
|
Change in Tumor Necrosis Factor-alpha Level
時間枠:Baseline, postoperative 6 hours, and postoperative 24 hours
|
Tumor necrosis factor-alpha level was measured from blood samples as an inflammatory biomarker.
|
Baseline, postoperative 6 hours, and postoperative 24 hours
|
|
Change in C-reactive Protein Level
時間枠:Baseline, postoperative 6 hours, and postoperative 24 hours
|
C-reactive protein level was measured from blood samples as an inflammatory biomarker.
|
Baseline, postoperative 6 hours, and postoperative 24 hours
|
|
Change in Blood Glucose Level
時間枠:Baseline, postoperative 6 hours, and postoperative 24 hours
|
Blood glucose level was measured from blood samples during the perioperative follow-up period.
|
Baseline, postoperative 6 hours, and postoperative 24 hours
|
協力者と研究者
捜査官
捜査官
- スタディチェア:Ayşe Ceren Hilal Güven, assistant doctor、Ataturk University Department of Anesthesiology and Reanimation
出版物と役立つリンク
一般刊行物
- Casati A, Putzu M. Anesthesia in the obese patient: pharmacokinetic considerations. J Clin Anesth. 2005 Mar;17(2):134-45. doi: 10.1016/j.jclinane.2004.01.009.
- Schilling T, Kozian A, Senturk M, Huth C, Reinhold A, Hedenstierna G, Hachenberg T. Effects of volatile and intravenous anesthesia on the alveolar and systemic inflammatory response in thoracic surgical patients. Anesthesiology. 2011 Jul;115(1):65-74. doi: 10.1097/ALN.0b013e318214b9de.
- Garlanda C, Bottazzi B, Bastone A, Mantovani A. Pentraxins at the crossroads between innate immunity, inflammation, matrix deposition, and female fertility. Annu Rev Immunol. 2005;23:337-66. doi: 10.1146/annurev.immunol.23.021704.115756.
- Kramer GC, et al. Monitoring intraoperative urine output: A good indicator of tissue perfusion? Crit Care Clin. 2004;20(2):213-225. doi:10.1016/j.ccc.2004.01.002
- Zoremba N, Dette F, Eberhart LH, Mischkowski D, Sümpelmann R, Graf BM. Bispectral index and entropy for monitoring the hypnotic effects of sevoflurane and propofol. Anesth Analg. 2007;105(6):1721-1727. doi:10.1213/01.ane.0000290546.37250.10
- Inoue S, Tanaka Y, Kawaguchi M. Propofol and volatile anesthetics differently affect systemic inflammatory responses during surgery. Can J Anaesth. 2015;62(5):522-530. doi:10.1007/s12630-015-0345-6
- Helmy SA, Al-Attiyah RJ, El-Touny MA. Immunomodulatory effects of sevoflurane compared to propofol in patients undergoing laparoscopic cholecystectomy. Saudi J Anaesth. 2015 Apr-Jun;9(2):170-174. doi:10.4103/1658-354X.152849
- Hynninen MS, Hurme M, Ala-Kokko TI. Novel biomarkers of sepsis. Ann Med. 2006;38(4):234-242. doi:10.1080/07853890600651816
- Uhlar CM, Whitehead AS. Serum amyloid A, the major vertebrate acute-phase reactant. Eur J Biochem. 1999 Oct;265(2):501-23. doi: 10.1046/j.1432-1327.1999.00657.x.
- Draisci G, Aceto P, Vollono C, Zanatta P, Pinto G, Sacco T, Carpenedo R. Anaesthetic strategies in obese patients. Curr Opin Anaesthesiol. 2017 Feb;30(1):117-124. doi:10.1097/ACO.0000000000000419
研究記録日
主要日程の研究
研究開始 (実際)
研究開始
一次修了 (推定)
一次修了
研究の完了 (推定)
研究の完了
試験登録日
最初に提出
最初に提出
QC基準を満たした最初の提出物
QC基準を満たした最初の提出物
最初の投稿 (実際)
最初の投稿
学習記録の更新
投稿された最後の更新 (実際)
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QC基準を満たした最後の更新が送信されました
QC基準を満たした最後の更新が送信されました
最終確認日
最終確認日
詳しくは
本研究に関する用語
追加の関連 MeSH 用語
その他の研究ID番号
その他の研究ID番号
- B.30.2.ATA.0.01.00/465
- 2025/2 (その他の識別子:Atatürk University Clinical Research Ethics Committee)
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