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- Klinische proef NCT07665645
Postoperative Cognitive Function After Different Anesthetic Techniques in Obese Patients
Effects of Low-Flow Sevoflurane, Normal-Flow Sevoflurane, and Total Intravenous Anesthesia on Postoperative Cognitive Function in Obese Patients Undergoing Laparoscopic Abdominal Surgery
Studie Overzicht
Toestand
Interventie / Behandeling
Gedetailleerde beschrijving
Obesity is associated with physiological alterations that may increase the risk of postoperative cognitive dysfunction (POCD). The influence of anesthetic techniques on postoperative cognitive outcomes in obese patients remains uncertain.
This prospective randomized study was conducted in obese patients (BMI ≥30 kg/m²) aged 18-65 years undergoing elective laparoscopic abdominal surgery under general anesthesia. Patients were randomly assigned to one of three groups: low-flow sevoflurane anesthesia, normal-flow sevoflurane anesthesia, or total intravenous anesthesia (TIVA). Anesthetic depth was monitored using bispectral index (BIS) monitoring and maintained between 40 and 60 in all groups.
The primary objective was to compare postoperative cognitive function among the three anesthetic techniques using the Mini-Mental State Examination (MMSE). MMSE scores were evaluated preoperatively, at postoperative 30 minutes, and on postoperative day 3.
Secondary objectives included comparison of recovery characteristics, including eye-opening time, extubation time, Modified Aldrete Recovery Scores, and perioperative hemodynamic parameters.
The study was approved by the Marmara University Faculty of Medicine Clinical Research Ethics Committee (Approval No. 09.2022.744) and written informed consent was obtained from all participants before enrollment.
Studietype
Inschrijving (Werkelijk)
Fase
- Niet toepasbaar
Contacten en locaties
Studie Locaties
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Istanbul
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Istanbul, Istanbul, Turkije (Türkiye), 34899
- Marmara University Faculty of Medicine Pendik Training and Research Hospital
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Deelname Criteria
Geschiktheidscriteria
Leeftijden die in aanmerking komen voor studie
- Volwassen
- Oudere volwassene
Accepteert gezonde vrijwilligers
Beschrijving
Inclusion Criteria:
- Age between 18 and 65 years
- Body mass index (BMI) ≥30 kg/m²
- ASA physical status I-III
- Scheduled for elective laparoscopic abdominal surgery
- Provision of written informed consent
Exclusion Criteria:
- History of psychiatric disease
- Dementia or known cognitive impairment
- Hearing or language disorders preventing MMSE assessment
- Refusal to participate
- Conversion from laparoscopic to open surgery
Studie plan
Hoe is de studie opgezet?
Ontwerpdetails
- Primair doel: Behandeling
- Toewijzing: Gerandomiseerd
- Interventioneel model: Parallelle opdracht
- Masker: Dubbele
Wapens en interventies
Deelnemersgroep / Arm |
Interventie / Behandeling |
|---|---|
|
Experimenteel: Low-Flow Sevoflurane
Patients received sevoflurane anesthesia with a fresh gas flow of 1 L/min during maintenance of anesthesia.
Anesthetic depth was maintained with BIS values between 40 and 60.
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Maintenance of general anesthesia with sevoflurane inhalation.
Patients were assigned to either low-flow (1 L/min) or normal-flow (3 L/min) fresh gas flow anesthesia protocols.
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Experimenteel: Normal-Flow Sevoflurane
Patients received sevoflurane anesthesia with a fresh gas flow of 3 L/min during maintenance of anesthesia.
Anesthetic depth was maintained with BIS values between 40 and 60.
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Maintenance of general anesthesia with sevoflurane inhalation.
Patients were assigned to either low-flow (1 L/min) or normal-flow (3 L/min) fresh gas flow anesthesia protocols.
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Experimenteel: Total Intravenous Anesthesia (TIVA)
Patients received total intravenous anesthesia with propofol and remifentanil infusion.
Anesthetic depth was maintained with BIS values between 40 and 60.
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Maintenance of total intravenous anesthesia using continuous propofol infusion under BIS monitoring.
Continuous remifentanil infusion was administered during maintenance of anesthesia according to study protocol.
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Wat meet het onderzoek?
Primaire uitkomstmaten
Uitkomstmaat |
Maatregel Beschrijving |
Tijdsspanne |
|---|---|---|
|
Mini-Mental State Examination (MMSE) Score
Tijdsspanne: Preoperative, postoperative 30 minutes, and postoperative day 3
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Postoperative cognitive function assessed using the Mini-Mental State Examination (MMSE).
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Preoperative, postoperative 30 minutes, and postoperative day 3
|
Secundaire uitkomstmaten
Uitkomstmaat |
Maatregel Beschrijving |
Tijdsspanne |
|---|---|---|
|
Eye Opening Time
Tijdsspanne: End of surgery
|
Time from discontinuation of anesthetic administration to spontaneous eye opening
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End of surgery
|
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Extubation Time
Tijdsspanne: End of surgery
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Time from discontinuation of anesthetic administration to tracheal extubation.
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End of surgery
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Modified Aldrete Recovery Score
Tijdsspanne: Postoperative recovery period
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Recovery status assessed using the Modified Aldrete Score.
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Postoperative recovery period
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heart rate
Tijdsspanne: During surgery
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patient's intraoperative measured heart rate
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During surgery
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mean arterial pressure
Tijdsspanne: during surgery
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patient's intraoperative measured mean arterial pressure
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during surgery
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oxygen saturation
Tijdsspanne: During surgery
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oxygen saturation of the patient will be recorded
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During surgery
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end-tidal carbon dioxide
Tijdsspanne: During surgery
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end-tidal carbon dioxide of the patient will be recorded
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During surgery
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Medewerkers en onderzoekers
Sponsor
Onderzoekers
- Hoofdonderzoeker: Ahmet Tunca, MD, Department of Anesthesiology and Reanimation, Gaziantep City Hospital
- Studie stoel: Seniyye Ü Zengin, MD, Department of Anesthesiology and Reanimation, Marmara University Faculty of Medicine, Pendik Training and Research Hospital
- Studie directeur: Meliha O Ergün, MD, Department of Anesthesiology and Reanimation, Marmara University Faculty of Medicine, Pendik Training and Research Hospital
Studie record data
Bestudeer belangrijke data
Studie start (Werkelijk)
Primaire voltooiing (Werkelijk)
Studie voltooiing (Werkelijk)
Studieregistratiedata
Eerst ingediend
Eerst ingediend dat voldeed aan de QC-criteria
Eerst geplaatst (Werkelijk)
Updates van studierecords
Laatste update geplaatst (Werkelijk)
Laatste update ingediend die voldeed aan QC-criteria
Laatst geverifieerd
Meer informatie
Termen gerelateerd aan deze studie
Trefwoorden
Aanvullende relevante MeSH-voorwaarden
- Voedingsstoornissen
- Overvoeding
- Lichaamsgewicht
- Overgewicht
- Pathologische aandoeningen, tekenen en symptomen
- Voedings- en stofwisselingsziekten
- Tekenen en symptomen
- Obesitas
- Organische chemicaliën
- Heterocyclische verbindingen, 1-ring
- Heterocyclische verbindingen
- Ethers
- Koolwaterstoffen
- Koolwaterstoffen, cyclisch
- Zuren, acyclisch
- Carbonzuren
- Koolwaterstoffen, aromatisch
- Piperidines
- Fenolen
- Benzeenderivaten
- Koolwaterstoffen, gehalogeneerd
- Koolwaterstoffen, gefluoreerd
- Propionaten
- Methylethers
- Remifentanil
- Sevofluraan
- Propofol
Andere studie-ID-nummers
- MU-09.2022.744
Plan Individuele Deelnemersgegevens (IPD)
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