Evaluation of Neurotoxic Effect of Sevoflurane-Based AnaesthesiaGuided by Short-Term Olfactory Identification

Tanta University

Status: Completed

Conditions: Neurotoxic Effect of Sevoflurane-Based Anaesthesia

Treatments: Drug: Sevoflurane

Study type: Observational

Funder types: Other

Identifiers

NCT03726580

TantaF

Details and patient eligibility

About

Nowadays there is increasing doubts about the safety of anesthesia . Anesthesiologists have to console the worried patients, who are anxious about the potential risks of anesthetic-induced brain damage, by suggesting that any detrimental effects would be "mild".Anesthetics are responsible for postoperative taste and odor defects and cognitive dysfunction.

Full description

Aims: The aim of this study is to assess the effect of isoflurane, sevoflurane, propofol and regional anesthesia on the olfactory threshold, olfactory identification and endocrine regulation of associative memory in the postoperative period in old age group.

Methods: 600 patients (> 60years ) fulfilling the criteria of the American society of anesthesiologists and II status were selected for this prospective single-blinded randomized controlled study. Patients were randomized into one of four groups to receive regional anesthesia (control group), general anesthesia with sevoflurane, general anesthesia with isoflurane and total intravenous anesthesia with propofol.

Mini-Mental State Examination (MMSE), olfactory threshold, and olfactory identification were tested at 12 hours preoperatively (T0), at 3 hours postoperatively (T1) and at the time of discharge or postoperative 3 days (T2). In addition, serum melatonin levels were estimated at T0 and T1.

N-butyl alcohol was used to test the olfactory threshold and the Pocket Smell Test TM series (PSTs) was used to test olfactory identification. Data were analyzed using the one-way analysis of variance, Kruskal-Wallis or Mann-Whitney tests.

Enrollment: 600 patients

Sex: All

Ages: 60 to 75 years old

Volunteers: Accepts Healthy Volunteers

Inclusion criteria

• American Society of Anaesthesiologists I and II physical status
• aged from 60 to 75years
• scheduled for elective surgery with the anticipated duration of 100-120 min.
• surgical procedures included hernia repair,
• varicose vein surgery,
• incisional hernia repair,
• minor gynecological procedures,
• lower limb orthopedic procedures,
• minor urological procedures

Exclusion criteria

• Patients with recent airway infection,
• allergic rhinitis,
• nasal polyps,
• history of alcoholism,
• smoking,
• mental retardation,
• psychiatric illness,
• neurosurgical or oto-rhino-laryngeal surgery
• patients with a history of olfactory deficits and cognitive impairment

Trial design

600 participants in 4 patient groups

control group

Description:

regional anesthesia

general anesthesia(S)

Description:

general anesthesia with sevoflurane

Treatment:

Drug: Sevoflurane

general anesthesia(I)

Description:

general anesthesia with isoflurane

total intravenous anesthesia

Description:

total intravenous anesthesia with propofol.