Conversion From Total Intravenous Anesthesia Technique to Desflurane Anesthesia for Long Duration Neurosurgery

Tokyo Women's Medical University

Status and phase: Unknown; Phase 4

Conditions: Patients Undergoing Elective Craniotomy

Treatments: Drug: Propofol; Drug: Desflurane

Study type: Interventional

Funder types: Other; Industry

Identifiers

NCT01985854

TIVA DES conversion

Details and patient eligibility

About

Since neurological testing during neurosurgery, such as somato-sensory evoked potentials, motor-evoked potentials, auditory evoked potentials and visual evoked potentials are well maintained their wave-form reactivity with total intravenous anaesthesia technique better than inhalational anesthetic techniques, the standard anesthesia method for neurosurgery is usually total intravenous anaesthesia technique. Nonetheless, after finishing recording the evoked potential responses during surgery, facilitation of recovery from general anesthesia is getting important, because the real neurological physical examination is much more sensitive than above electrical evoked potentials to evaluate the results of surgical operation.

We propose to evaluate the recovery parameters after conversion from total intravenous anaesthesia technique to Desflurane anesthesia during long term neurosurgery procedures. The conversion will be initiated upon completion of the neurophysiological electric evoked potentials assessment. Based on the pharmacological properties of desflurane, we hypothesize that recovery after conversion to Desflurane will be faster compared to recovery after total intravenous anaesthesia alone.

Enrollment: 60 estimated patients

Sex: All

Ages: 20 to 65 years old

Volunteers: No Healthy Volunteers

Inclusion criteria

• Patients undergoing elective craniotomy
• American Society of Anesthesiology Physical Status Ⅰ, II and III
• Age: between 20 to 65 years
• Sex: male or female
• Patients who are postmenopausal or surgically sterilized
• Expected Operation time is longer than 4 hours.

Exclusion criteria

Trial design

Primary purpose: Treatment

Allocation: Randomized

Interventional model: Parallel Assignment

Masking: Single Blind

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60 participants in 2 patient groups

Propofol

Active Comparator group

Description:

Propofol target-controlled infusion will be kept 2-4μg /ml plasma concentration throughout procedure.

Treatment:

Drug: Propofol

Desflurane

Experimental group

Description:

After taking off the electrophysiological monitoring from the patients, discontinue propofol and start desflurane from 6% (dialed concentration) at flow rate of 4L/min for 2 minutes in desflurane group. When achieve end tidal concentration of 4-5%, decrease the flow rate to 2L/min.

Treatment:

Drug: Desflurane