Factors Affecting the Effective End-tidal Concentration of Desflurane Anaesthesia

University Hospital Hradec Kralove

Status: Completed

Conditions: General Anesthetic Drug Adverse Reaction

Treatments: Drug: desflurane - oxygen in nitric oxide; Drug: desflurane - oxygen in air

Study type: Interventional

Funder types: Other

Identifiers

NCT02617680

201404515P

Details and patient eligibility

About

There is accumulating evidence that inappropriate depth of anaesthesia is associated with increased risk of postoperative complications including risk of death. The aim of this study was to identify factors determining the effective end-tidal concentration (EEtC) of desflurane, duration of wash in and wash out phase, and to estimate the risk of perioperative awareness in patients undergoing elective neurosurgical procedure.

Full description

All patients with American Society of Anesthesiologists (ASA) physical status I-III scheduled for elective neurosurgical procedure under general anaesthesia are studied. In each individual, the manufacturer recommended age-corrected end-tidal concentrations of desflurane is set and achieved initially. Individual effective end-tidal concentration (EEtC) of desflurane is then defined according to entropy parameters and maintained in the targeted range of static and response entropy 40-50. Effective analgesia is maintained according to surgical plethysmographic index (SPI) and dose of muscle relaxants according to neuromuscular transmission monitoring (TOF). Comorbidity, regular intake of alcohol and medication, smoking, sex, weight, height, and age are recorded. Postoperative questionnaire is used to reveal the intraoperative awareness.

Enrollment: 80 patients

Sex: All

Ages: 18 to 78 years old

Volunteers: No Healthy Volunteers

Inclusion criteria

• ASA I-III
• elective neurosurgical procedure under general anaesthesia
• Age between 18 and 78
• elective procedures with estimated duration 1 - 3 hours

Exclusion criteria

• Glasgow coma scale GCS below 14
• other rhythm than sinus
• pacemaker stimulation
• planned postoperative ventilation

Trial design

Primary purpose: Treatment

Allocation: Non-Randomized

Interventional model: Parallel Assignment

Masking: Single Blind

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80 participants in 2 patient groups

desflurane - oxygen in air

Experimental group

Description:

The manufacturer recommended age-corrected end-tidal concentrations of desflurane in air should be set and achieved initially. Concentration of oxygen should be 50%.

Treatment:

Drug: desflurane - oxygen in air

desflurane - oxygen in nitric oxide

Experimental group

Description:

The manufacturer recommended age-corrected end-tidal concentrations of desflurane with nitric oxide - oxygen should be set and achieved initially.Concentration of oxygen should be 50%.

Treatment:

Drug: desflurane - oxygen in nitric oxide