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Comparison of Desflurane, Sevoflurane, and Total Intravenous Anesthesia in Ear Surgery Under Controlled Hypotension (POCD-ENT)

26. august 2026 oppdatert av: MELİS ŞEN, Dr. Lutfi Kirdar Kartal Training and Research Hospital

Comparison of Desflurane, Sevoflurane, and Total Intravenous Anesthesia Methods in Terms of Postoperative Cognitive Dysfunction in Ear Surgery Performed Under Controlled Hypotension

This randomized prospective study aimed to compare desflurane, sevoflurane, and total intravenous anesthesia methods in patients undergoing elective ear surgery under controlled hypotension, with a particular focus on postoperative cognitive dysfunction. In addition to cognitive outcomes, intraoperative hemodynamic parameters, cerebral oxygenation, and perioperative clinical outcomes were evaluated and compared among the three groups.

Studieoversikt

Status

Fullført

Forhold

Intervensjon / Behandling

Detaljert beskrivelse

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

Intervensjonell

Registrering (Faktiske)

69

Fase

  • Ikke aktuelt

Kontakter og plasseringer

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

Studiesteder

  • Tyrkia (Türkiye)
    • Istanbul
      • Istanbul, Istanbul, Tyrkia (Türkiye), 34865
        • Kartal Dr. Lutfi Kirdar City Hospital

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 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

Studieplan

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

Hvordan er studiet utformet?

Designdetaljer

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

Våpen og intervensjoner

Deltakergruppe / Arm
Intervensjon / Behandling
Eksperimentell: Desflurane-Remifentanil Group
Legemiddel: Desflurane
Used for maintenance of anesthesia.
Legemiddel: Remifentanil
Used for maintenance of anesthesia.
Eksperimentell: Sevoflurane-Remifentanil Group
Patients received general anesthesia with sevoflurane for maintenance and remifentanil infusion.
Legemiddel: Remifentanil
Used for maintenance of anesthesia.
Legemiddel: Sevoflurane
Used for maintenance of anesthesia.
Eksperimentell: Total Intravenous Anesthesia (Propofol-Remifentanil) Group
Patients received total intravenous anesthesia with propofol and remifentanil infusion.
Legemiddel: Remifentanil
Used for maintenance of anesthesia.
Legemiddel: Propofol (Astra-Zeneca)
Used for maintenance of anesthesia.

Hva måler studien?

Primære resultatmål

Resultatmål
Tiltaksbeskrivelse
Tidsramme
Postoperative cognitive function (POCD)
Tidsramme: 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

Sekundære resultatmål

Resultatmål
Tiltaksbeskrivelse
Tidsramme
Intraoperative cerebral oxygen saturation (rSO2)
Tidsramme: 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
Tidsramme: 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
Tidsramme: 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
Tidsramme: 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
Tidsramme: 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
Tidsramme: 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.

Samarbeidspartnere og etterforskere

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

Sponsor

Dr. Lutfi Kirdar Kartal Training and Research Hospital

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)

1. desember 2023

Primær fullføring (Faktiske)

31. juli 2024

Studiet fullført (Faktiske)

31. juli 2024

Datoer for studieregistrering

Først innsendt

21. mars 2026

Først innsendt som oppfylte QC-kriteriene

26. august 2026

Først lagt ut (Faktiske)

28. august 2026

Oppdateringer av studieposter

Sist oppdatering lagt ut (Faktiske)

28. august 2026

Siste oppdatering sendt inn som oppfylte QC-kriteriene

26. august 2026

Sist bekreftet

1. mars 2026

Mer informasjon

Begreper knyttet til denne studien

Nøkkelord

Ytterligere relevante MeSH-vilkår

Andre studie-ID-numre

  • KDLH-POCD-ENT-2024

Plan for individuelle deltakerdata (IPD)

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Legemiddel- og utstyrsinformasjon, studiedokumenter

Studerer et amerikansk FDA-regulert medikamentprodukt

Nei

Studerer et amerikansk FDA-regulert enhetsprodukt

Nei

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