Total Intravenous Anesthesia Versus Inhalation Anesthesia on Postoperative Liver Function

Benha University

Status: Completed

Conditions: Laparoscopic Sleeve Gastrectomy

Treatments: Drug: Total intravenous anesthesia group; Drug: sevoflurane group

Study type: Interventional

Funder types: Other

Identifiers

NCT06423846

RC-3-4-2024

Details and patient eligibility

About

The pandemic of obesity has become a serious issue of public health worldwide as the size of the obese population has almost tripled over the last four decades and continues to riseزThe epidemic of obesity has led to a significant increase in the prevalence of non-alcoholic fatty liver disease (NAFLD). NAFLD is currently the most common chronic liver disease, with an estimated global prevalence at 25-30%, rising up to 90% in morbidly obese patients

Full description

Anesthesia and surgery may deteriorate liver function in patients with elevated liver enzyme levels; therefore, in these patients, choosing anaesthetics with less hepatotoxicity may be important. Halothane, which is a typical inhalational anesthetic, is known for its liver and kidney toxicity. The latest anesthetic agents, including sevoflurane and desflurane, are associated with less hepatotoxicity, although rare cases of acute liver injury have been reported with these agentsزPropofol (2,6-diisopropylphenol) is an intravenous anesthetic. Its pharmacokinetic profile makes it very suitable for total intravenous anesthesia (TIVA) and this is a widely used technique in many centers. Its use results in a rapid onset and offset with fewer side effects including postoperative nausea and vomiting, making it particularly favorable in the ambulatory setting

Enrollment: 80 patients

Sex: All

Ages: 20 to 70 years old

Volunteers: No Healthy Volunteers

Inclusion criteria

• Obese patients
• had ASA I-III
• diagnosed with non-alcoholic steatohepatitis (NASH) liver disease
• undergoing laparoscopic sleeve gastrectomy

Exclusion criteria

• cases wherein surgeries were performed using anesthetic methods that were not clearly identified as TIVA or INHA
• heart surgery or cesarean section, and cases of neuromuscular diseases

Trial design

Primary purpose: Prevention

Allocation: Randomized

Interventional model: Parallel Assignment

Masking: None (Open label)

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80 participants in 2 patient groups

total intravenous anesthesia group

Experimental group

Description:

Patients in the TIVA group had anesthesia induced with propofol 2 mg/kg , fentanyl 1 ug/kg and maintained with propofol.

Treatment:

Drug: Total intravenous anesthesia group

sevoflurane group

Experimental group

Description:

general anesthesia was induced with propofol 2 mg/kg, fentanyl 1 ug/kg and then maintained with sevoflurane in air and oxygen, dexmedetomidine 1 ug/kg/hour.

Treatment:

Drug: sevoflurane group