Bispectral Index-Guided Versus Fixed Dose Administration of Desflurane During Balanced Anesthesia With Remifentanil

Seoul National University

Status: Completed

Conditions: Stabilizing Hypnotic Depth and Vital Sign During Balanced Anesthesia

Treatments: Drug: Administering desflurane at 1 MAC; Drug: Administering desflurane according to the patient's BIS value

Study type: Interventional

Funder types: Other

Identifiers

NCT02283866

CWJung_BA

Details and patient eligibility

About

Balanced anesthesia combining volatile anesthetics and opioids is commonly used in modern anesthesia. The purpose of this study is to compare two methods of administering desflurane, an volatile anesthetic during balanced anesthesia. The investigators hypothesized that administering desflurane at 1 MAC (minimum alveolar concentration) during balanced anesthesia will be more beneficial in terms of stability of the patient's vital signs and hypnotic depth than administering desflurane according to the patient's BIS (bispectral index) value.

Enrollment: 48 patients

Sex: All

Ages: 20 to 90 years old

Volunteers: No Healthy Volunteers

Inclusion criteria

• Patients scheduled for operation under balanced anesthesia using desflurane and remifentanil

Exclusion criteria

• Refusal of consent
• General anesthesia with agents other than desflurane and remifentanil
• Patients with allergy to neuromuscular blocker, volatile anesthetics, opioids
• History of malignant hyperthermia
• Patients taking CNS stimulants
• Chronic alcohol abuser
• Patients with severe depressed left ventricular function, EF < 30%
• Patients with convulsive disorders
• ASA class IV, V, VI
• Patients with systolic arterial blood pressure lower than 90mmHg before surgery
• Patients needing inotropic infusion during surgery
• Anesthesia time less than 30 minutes

Trial design

Primary purpose: Supportive Care

Allocation: Randomized

Interventional model: Parallel Assignment

Masking: Triple Blind

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48 participants in 2 patient groups

Administering desflurane according to the patient's BIS value

Experimental group

Description:

The anesthesiologist administers the volatile anesthetic desflurane to set the patient's BIS value at 50 during balanced anesthesia, and titrate the remifentanil dose to set the patient's systolic arterial blood pressure between 100-140mmHg.

Treatment:

Drug: Administering desflurane according to the patient's BIS value

Administering desflurane at 1 MAC

Experimental group

Description:

The anesthesiologist administers the volatile anesthetic desflurane at 1 MAC during balanced anesthesia, and titrate the remifentanil dose to set the patient's systolic arterial blood pressure between 100-140mmHg.

Treatment:

Drug: Administering desflurane at 1 MAC