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Comparison of Desflurane, Sevoflurane, and Total Intravenous Anesthesia in Ear Surgery Under Controlled Hypotension (POCD-ENT)
Comparison of Desflurane, Sevoflurane, and Total Intravenous Anesthesia Methods in Terms of Postoperative Cognitive Dysfunction in Ear Surgery Performed Under Controlled Hypotension
Studie Overzicht
Toestand
Interventie / Behandeling
Gedetailleerde beschrijving
Controlled hypotension is commonly used in ear surgery to reduce intraoperative bleeding and improve the surgical field. However, the effects of different anesthetic maintenance techniques used during controlled hypotension on postoperative cognitive function remain unclear.
This prospective randomized study included adult patients undergoing elective ear surgery. Patients were randomly assigned to receive desflurane, sevoflurane, or total intravenous anesthesia for maintenance of anesthesia under controlled hypotension.
The primary objective of the study was to evaluate postoperative cognitive dysfunction. Secondary objectives included comparison of intraoperative hemodynamic stability, cerebral oxygenation, and perioperative clinical outcomes among the three anesthesia techniques.
Hemodynamic parameters and cerebral oxygen saturation were recorded at predefined time points during the intraoperative period. Postoperative cognitive function was assessed using standardized cognitive evaluation methods.
The findings of this study aim to contribute to the selection of optimal anesthetic techniques in ear surgery performed under controlled hypotension.
Studietype
Inschrijving (Werkelijk)
Fase
- Niet toepasbaar
Contacten en locaties
Studie Locaties
-
-
Istanbul
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Istanbul, Istanbul, Turkije (Türkiye), 34865
- Kartal Dr. Lutfi Kirdar City Hospital
-
-
Deelname Criteria
Geschiktheidscriteria
Leeftijden die in aanmerking komen voor studie
- Volwassen
- Oudere volwassene
Accepteert gezonde vrijwilligers
Beschrijving
Inclusion Criteria:
- Patients aged 18 years and older
- ASA physical status I-II
- Scheduled for elective tympanoplasty, mastoidectomy, or tympanomastoidectomy under general anesthesia
- Provided written informed consent
Exclusion Criteria:
- Patients with known neurological or psychiatric disorders affecting cognitive function
- Pre-existing cognitive impairment
- Severe hepatic or renal insufficiency
- History of alcohol or substance abuse
- Inability to complete cognitive function tests
- Emergency surgery
- Refusal to participate in the study
Studie plan
Hoe is de studie opgezet?
Ontwerpdetails
- Primair doel: Ander
- Toewijzing: Gerandomiseerd
- Interventioneel model: Parallelle opdracht
- Masker: Enkel
Wapens en interventies
Deelnemersgroep / Arm |
Interventie / Behandeling |
|---|---|
|
Experimenteel: Desflurane-Remifentanil Group
|
Used for maintenance of anesthesia.
Used for maintenance of anesthesia.
|
|
Experimenteel: Sevoflurane-Remifentanil Group
Patients received general anesthesia with sevoflurane for maintenance and remifentanil infusion.
|
Used for maintenance of anesthesia.
Used for maintenance of anesthesia.
|
|
Experimenteel: Total Intravenous Anesthesia (Propofol-Remifentanil) Group
Patients received total intravenous anesthesia with propofol and remifentanil infusion.
|
Used for maintenance of anesthesia.
Used for maintenance of anesthesia.
|
Wat meet het onderzoek?
Primaire uitkomstmaten
Uitkomstmaat |
Maatregel Beschrijving |
Tijdsspanne |
|---|---|---|
|
Postoperative cognitive function (POCD)
Tijdsspanne: Preoperative baseline and postoperative day 7
|
Postoperative cognitive function was evaluated using standardized neurocognitive tests before surgery and on postoperative day 7. Changes from baseline were analyzed to assess postoperative cognitive dysfunction.
|
Preoperative baseline and postoperative day 7
|
Secundaire uitkomstmaten
Uitkomstmaat |
Maatregel Beschrijving |
Tijdsspanne |
|---|---|---|
|
Intraoperative cerebral oxygen saturation (rSO2)
Tijdsspanne: Preoperative baseline (T0); 5, 15, 30, 45, and 60 minutes after intubation (T1-T5); and 5 and 15 minutes after extubation (T6-T7).
|
Regional cerebral oxygen saturation (rSO2) was continuously monitored intraoperatively using near-infrared spectroscopy (NIRS) and compared between groups at predefined time points.
|
Preoperative baseline (T0); 5, 15, 30, 45, and 60 minutes after intubation (T1-T5); and 5 and 15 minutes after extubation (T6-T7).
|
|
Mean Arterial Pressure
Tijdsspanne: Preoperative baseline (T0); 5, 15, 30, 45, and 60 minutes after intubation (T1-T5); and 5 and 15 minutes after extubation (T6-T7).
|
Mean arterial pressure (MAP) was recorded intraoperatively at predefined time points and compared between the three anesthesia groups.
|
Preoperative baseline (T0); 5, 15, 30, 45, and 60 minutes after intubation (T1-T5); and 5 and 15 minutes after extubation (T6-T7).
|
|
Arterial Partial Pressure of Oxygen
Tijdsspanne: 15 minutes (T2) and 60 minutes (T5) after intubation.
|
Arterial partial pressure of oxygen (PaO₂) was measured intraoperatively at predefined time points and compared between the three anesthesia groups.
|
15 minutes (T2) and 60 minutes (T5) after intubation.
|
|
Heart Rate
Tijdsspanne: Preoperative baseline (T0); 5, 15, 30, 45, and 60 minutes after intubation (T1-T5); and 5 and 15 minutes after extubation (T6-T7).
|
Heart rate (HR) was recorded intraoperatively at predefined time points and compared between the three anesthesia groups.
|
Preoperative baseline (T0); 5, 15, 30, 45, and 60 minutes after intubation (T1-T5); and 5 and 15 minutes after extubation (T6-T7).
|
|
Arterial Partial Pressure of Carbon Dioxide
Tijdsspanne: 15 minutes (T2) and 60 minutes (T5) after intubation.
|
Arterial partial pressure of carbon dioxide (PaCO₂) was measured intraoperatively at predefined time points and compared between the three anesthesia groups.
|
15 minutes (T2) and 60 minutes (T5) after intubation.
|
|
Blood Lactate Level
Tijdsspanne: 15 minutes (T2) and 60 minutes (T5) after intubation.
|
Blood lactate level was measured intraoperatively at predefined time points and compared between the three anesthesia groups.
|
15 minutes (T2) and 60 minutes (T5) after intubation.
|
Medewerkers en onderzoekers
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
- Psychische aandoening
- Postoperatieve complicaties
- Pathologische processen
- Neurocognitieve stoornissen
- Cognitieve stoornissen
- Cognitieve disfunctie
- Pathologische aandoeningen, tekenen en symptomen
- Postoperatieve cognitieve complicaties
- 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
- Ethylethers
- Remifentanil
- Desfluraan
- Sevofluraan
- Propofol
Andere studie-ID-nummers
- KDLH-POCD-ENT-2024
Plan Individuele Deelnemersgegevens (IPD)
Bent u van plan om gegevens van individuele deelnemers (IPD) te delen?
Informatie over medicijnen en apparaten, studiedocumenten
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