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Sevoflurane vs Propofol Anesthesia in Obese Patients Undergoing Lumbar Surgery

20 maj 2026 uppdaterad 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.

Studieöversikt

Status

Rekrytering

Betingelser

Intervention / Behandling

Detaljerad beskrivning

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.

Studietyp

Interventionell

Inskrivning (Beräknad)

70

Fas

  • Inte tillämpbar

Kontakter och platser

Det här avsnittet innehåller kontaktuppgifter för dem som genomför studien och information om var denna studie genomförs.

Studiekontakt

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

Studera Kontakt Backup

Studieorter

  • Turkiet (Türkiye)
      • Erzurum, Turkiet (Türkiye), 25000
        • Rekrytering
        • Ataturk University
        • Kontakt:
          • Ayşe Ceren Hilal Güven, assistant doctor
          • Telefonnummer: 554-112-25-81
          • E-post: achg1995@gmail.com

Deltagandekriterier

Forskare letar efter personer som passar en viss beskrivning, så kallade behörighetskriterier. Några exempel på dessa kriterier är en persons allmänna hälsotillstånd eller tidigare behandlingar.

Urvalskriterier

Åldrar som är berättigade till studier

  • Vuxen
  • Äldre vuxen

Tar emot friska volontärer

Nej

Beskrivning

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

Det här avsnittet ger detaljer om studieplanen, inklusive hur studien är utformad och vad studien mäter.

Hur är studien utformad?

Designdetaljer

  • Primärt syfte: Grundläggande vetenskap
  • Tilldelning: Randomiserad
  • Interventionsmodell: Parallellt uppdrag
  • Maskning: Enda

Vapen och interventioner

Deltagargrupp / Arm
Intervention / Behandling
Experimentell: 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.
Läkemedel: Propofol (Astra-Zeneca)
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.
Experimentell: 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.
Läkemedel: Sevoflurane
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.

Vad mäter studien?

Primära resultatmått

Resultatmått
Åtgärdsbeskrivning
Tidsram
Change in Pentraxin 3 Level
Tidsram: 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
Tidsram: 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

Sekundära resultatmått

Resultatmått
Åtgärdsbeskrivning
Tidsram
Change in Interleukin-6 Level
Tidsram: 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
Tidsram: 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
Tidsram: 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
Tidsram: 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

Samarbetspartners och utredare

Det är här du hittar personer och organisationer som är involverade i denna studie.

Sponsor

Ataturk University

Utredare

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

Publikationer och användbara länkar

Den som ansvarar för att lägga in information om studien tillhandahåller frivilligt dessa publikationer. Dessa kan handla om allt som har med studien att göra.

Allmänna publikationer

Studieavstämningsdatum

Dessa datum spårar framstegen för inlämningar av studieposter och sammanfattande resultat till ClinicalTrials.gov. Studieposter och rapporterade resultat granskas av National Library of Medicine (NLM) för att säkerställa att de uppfyller specifika kvalitetskontrollstandarder innan de publiceras på den offentliga webbplatsen.

Studera stora datum

Studiestart (Faktisk)

15 juni 2025

Primärt slutförande (Beräknad)

15 juni 2026

Avslutad studie (Beräknad)

16 juni 2026

Studieregistreringsdatum

Först inskickad

7 maj 2026

Först inskickad som uppfyllde QC-kriterierna

20 maj 2026

Första postat (Faktisk)

28 maj 2026

Uppdateringar av studier

Senaste uppdatering publicerad (Faktisk)

28 maj 2026

Senaste inskickade uppdateringen som uppfyllde QC-kriterierna

20 maj 2026

Senast verifierad

1 maj 2026

Mer information

Termer relaterade till denna studie

Nyckelord

Ytterligare relevanta MeSH-villkor

Andra studie-ID-nummer

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

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