- ICH GCP
- 미국 임상 시험 레지스트리
- 임상시험 NCT07611240
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
연구 개요
상세 설명
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.
연구 유형
등록 (추정된)
단계
- 해당 없음
연락처 및 위치
연구 연락처
- 이름: Ayşe Ceren Hilal Güven, assistant doctor
- 전화번호: 554-112-25-81
- 이메일: achg1995@gmail.com
연구 연락처 백업
- 이름: Mehmet Akif Yilmaz, Doctor
- 전화번호: +905346533539
- 이메일: mehmetakifyilmaz025@gmail.com
연구 장소
-
-
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Erzurum, 터키 (Türkiye), 25000
- 모병
- Atatürk University
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연락하다:
- Ayşe Ceren Hilal Güven, assistant doctor
- 전화번호: 554-112-25-81
- 이메일: achg1995@gmail.com
-
-
참여기준
자격 기준
공부할 수 있는 나이
- 성인
- 고령자
건강한 자원 봉사자를 받아들입니다
설명
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
공부 계획
연구는 어떻게 설계됩니까?
디자인 세부사항
- 주 목적: 기초 과학
- 할당: 무작위
- 중재 모델: 병렬 할당
- 마스킹: 하나의
무기와 개입
참가자 그룹 / 팔 |
개입 / 치료 |
|---|---|
|
실험적: 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.
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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.
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실험적: 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.
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연구는 무엇을 측정합니까?
주요 결과 측정
결과 측정 |
측정값 설명 |
기간 |
|---|---|---|
|
Change in Pentraxin 3 Level
기간: Baseline, postoperative 6 hours, and postoperative 24 hours
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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
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Change in Serum Amyloid A Level
기간: Baseline, postoperative 6 hours, and postoperative 24 hours
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Serum amyloid A level was measured from blood samples to evaluate the inflammatory response after surgery.
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Baseline, postoperative 6 hours, and postoperative 24 hours
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2차 결과 측정
결과 측정 |
측정값 설명 |
기간 |
|---|---|---|
|
Change in Interleukin-6 Level
기간: Baseline, postoperative 6 hours, and postoperative 24 hours
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Interleukin-6 level was measured from blood samples as an inflammatory biomarker.
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Baseline, postoperative 6 hours, and postoperative 24 hours
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Change in Tumor Necrosis Factor-alpha Level
기간: Baseline, postoperative 6 hours, and postoperative 24 hours
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Tumor necrosis factor-alpha level was measured from blood samples as an inflammatory biomarker.
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Baseline, postoperative 6 hours, and postoperative 24 hours
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Change in C-reactive Protein Level
기간: Baseline, postoperative 6 hours, and postoperative 24 hours
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C-reactive protein level was measured from blood samples as an inflammatory biomarker.
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Baseline, postoperative 6 hours, and postoperative 24 hours
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Change in Blood Glucose Level
기간: Baseline, postoperative 6 hours, and postoperative 24 hours
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Blood glucose level was measured from blood samples during the perioperative follow-up period.
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Baseline, postoperative 6 hours, and postoperative 24 hours
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공동 작업자 및 조사자
수사관
- 연구 의자: Ayşe Ceren Hilal Güven, assistant doctor, Ataturk University Department of Anesthesiology and Reanimation
간행물 및 유용한 링크
일반 간행물
- 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
연구 기록 날짜
연구 주요 날짜
연구 시작 (실제)
기본 완료 (추정된)
연구 완료 (추정된)
연구 등록 날짜
최초 제출
QC 기준을 충족하는 최초 제출
처음 게시됨 (실제)
연구 기록 업데이트
마지막 업데이트 게시됨 (실제)
QC 기준을 충족하는 마지막 업데이트 제출
마지막으로 확인됨
추가 정보
이 연구와 관련된 용어
추가 관련 MeSH 약관
기타 연구 ID 번호
- B.30.2.ATA.0.01.00/465
- 2025/2 (기타 식별자: Atatürk University Clinical Research Ethics Committee)
개별 참가자 데이터(IPD) 계획
개별 참가자 데이터(IPD)를 공유할 계획입니까?
약물 및 장치 정보, 연구 문서
미국 FDA 규제 의약품 연구
미국 FDA 규제 기기 제품 연구
이 정보는 변경 없이 clinicaltrials.gov 웹사이트에서 직접 가져온 것입니다. 귀하의 연구 세부 정보를 변경, 제거 또는 업데이트하도록 요청하는 경우 register@clinicaltrials.gov. 문의하십시오. 변경 사항이 clinicaltrials.gov에 구현되는 즉시 저희 웹사이트에도 자동으로 업데이트됩니다. .
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