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Sevoflurane vs Propofol Anesthesia in Obese Patients Undergoing Lumbar Surgery

20. mai 2026 oppdatert av: Mehmet Akif Yilmaz, Ataturk University

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

This randomized, single-center, single-masked clinical trial aims to compare the immunomodulatory effects of sevoflurane-based inhalational anesthesia and propofol-based total intravenous anesthesia in obese patients undergoing elective lumbar instrumentation surgery. Seventy patients will be randomized into two groups: a propofol group and a sevoflurane group. Blood samples will be collected preoperatively, at postoperative 6 hours, and at postoperative 24 hours. Pentraxin-3 and serum amyloid A levels will be evaluated as primary inflammatory biomarkers together with IL-6, TNF-α, CRP, glucose, and complete blood count parameters.

Studieoversikt

Status

Rekruttering

Forhold

Intervensjon / Behandling

Detaljert beskrivelse

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.

Studietype

Intervensjonell

Registrering (Antatt)

70

Fase

  • Ikke aktuelt

Kontakter og plasseringer

Denne delen inneholder kontaktinformasjon for de som utfører studien, og informasjon om hvor denne studien blir utført.

Studiekontakt

  • Navn: Ayşe Ceren Hilal Güven, assistant doctor
  • Telefonnummer: 554-112-25-81
  • E-post: achg1995@gmail.com

Studer Kontakt Backup

Studiesteder

      • Erzurum, Tyrkia (Türkiye), 25000
        • Rekruttering
        • Ataturk University
        • Ta kontakt med:
          • Ayşe Ceren Hilal Güven, assistant doctor
          • Telefonnummer: 554-112-25-81
          • E-post: achg1995@gmail.com

Deltakelseskriterier

Forskere ser etter personer som passer til en bestemt beskrivelse, kalt kvalifikasjonskriterier. Noen eksempler på disse kriteriene er en persons generelle helsetilstand eller tidligere behandlinger.

Kvalifikasjonskriterier

Alder som er kvalifisert for studier

  • Voksen
  • Eldre voksen

Tar imot friske frivillige

Nei

Beskrivelse

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

Studieplan

Denne delen gir detaljer om studieplanen, inkludert hvordan studien er utformet og hva studien måler.

Hvordan er studiet utformet?

Designdetaljer

  • Primært formål: Grunnvitenskap
  • Tildeling: Randomisert
  • Intervensjonsmodell: Parallell tildeling
  • Masking: Enkelt

Våpen og intervensjoner

Deltakergruppe / Arm
Intervensjon / Behandling
Eksperimentell: 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.
Eksperimentell: 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.

Hva måler studien?

Primære resultatmål

Resultatmål
Tiltaksbeskrivelse
Tidsramme
Change in Pentraxin 3 Level
Tidsramme: 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.
Baseline, postoperative 6 hours, and postoperative 24 hours
Change in Serum Amyloid A Level
Tidsramme: 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

Sekundære resultatmål

Resultatmål
Tiltaksbeskrivelse
Tidsramme
Change in Interleukin-6 Level
Tidsramme: 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
Tidsramme: 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
Tidsramme: 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
Tidsramme: 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

Samarbeidspartnere og etterforskere

Det er her du vil finne personer og organisasjoner som er involvert i denne studien.

Sponsor

Etterforskere

  • Studiestol: Ayşe Ceren Hilal Güven, assistant doctor, Ataturk University Department of Anesthesiology and Reanimation

Publikasjoner og nyttige lenker

Den som er ansvarlig for å legge inn informasjon om studien leverer frivillig disse publikasjonene. Disse kan handle om alt relatert til studiet.

Generelle publikasjoner

Studierekorddatoer

Disse datoene sporer fremdriften for innsending av studieposter og sammendragsresultater til ClinicalTrials.gov. Studieposter og rapporterte resultater gjennomgås av National Library of Medicine (NLM) for å sikre at de oppfyller spesifikke kvalitetskontrollstandarder før de legges ut på det offentlige nettstedet.

Studer hoveddatoer

Studiestart (Faktiske)

15. juni 2025

Primær fullføring (Antatt)

15. juni 2026

Studiet fullført (Antatt)

16. juni 2026

Datoer for studieregistrering

Først innsendt

7. mai 2026

Først innsendt som oppfylte QC-kriteriene

20. mai 2026

Først lagt ut (Faktiske)

28. mai 2026

Oppdateringer av studieposter

Sist oppdatering lagt ut (Faktiske)

28. mai 2026

Siste oppdatering sendt inn som oppfylte QC-kriteriene

20. mai 2026

Sist bekreftet

1. mai 2026

Mer informasjon

Begreper knyttet til denne studien

Andre studie-ID-numre

  • B.30.2.ATA.0.01.00/465
  • 2025/2 (Annen identifikator: Atatürk University Clinical Research Ethics Committee)

Plan for individuelle deltakerdata (IPD)

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UBESLUTTE

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Studerer et amerikansk FDA-regulert medikamentprodukt

Nei

Studerer et amerikansk FDA-regulert enhetsprodukt

Nei

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