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AnesthesiaSerenityNCT04079036

Decision Support System for Anesthetists

An observational study of Anesthesia, run by University of Sao Paulo General Hospital at 1 site in Brazil.

Unknown status

Status not confirmed. The sponsor has not verified this record for over two years, so it may be out of date.

Official record
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Trial summary

The balanced anesthesia process contains three main parts: the control of hypnosis, analgesia, and neuromuscular blockade. For the induction phase, the anesthesiologist performs protocols based on prior planning specific to each patient and usually performs these controls by monitoring the classic vital signs and… Read more about this study

Who is it for?
Ages 1 month to 80 yearsHealthy volunteers can take part
Conditions the study is for
Anesthesia
How many people
360 participants
Where
1 siteBrazil
Study dates
Oct 2019to Jan 2020
How long will I take part?
20 Days
Phase
Observational
Are there results?
None posted in the registry

Key requirements

Who can take part, as listed by the sponsor. Only the study team can confirm whether you are eligible, so take this list to your doctor.

  • Ages 1 month to 80 years
  • All sexes
  • Healthy volunteers accepted
  • Child, Adult, Older adult

Study population: Patients undergoing surgical procedures with general anesthesia

Who may be able to join

  • Patients under general anesthesia

Who cannot join

  • Cerebral Palsy patients

Trial locations and contacts

1 site in 1 country.

Bruno B Turrin, Msc contact

+5511998745879

bbturrin@usp.br

Brazil1 site
  • Hospital das Clínicas - Faculdade de Medicina da Universidade de Sao Paulo

    São Paulo, 01246-903

Other trials in Brazil

About this study

Official title: Decision Support System for Anesthetists for In-room Monitoring of the Level of Consciousness, Neuro-muscular Blocking and Nociception Employing Data Fusion and Artificial Intelligence

The balanced anesthesia process contains three main parts: the control of hypnosis, analgesia, and neuromuscular blockade. For the induction phase, the anesthesiologist performs protocols based on prior planning specific to each patient and usually performs these controls by monitoring the classic vital signs and other clinical signs for the maintenance phase.

In a way, this professional is the controller in a control system that acts on the plant (the patient) through the infusion of hypnotic drugs, analgesics and neuromuscular blockers. In addition, the anesthesiologist estimates the state of consciousness, the level of analgesia and the level of neuromuscular blockage through other indirect measures, as well as a state observer.

There are different techniques for direct monitoring of these three anesthesia variables (DoA, NMB and NoL), such as BIS and Narcotrend, but all have some disadvantages, especially when the anesthesia process combines different drugs. This work proposes a new way of evaluating DoA, NMB and NoL using data fusion techniques to combine classical clinical signs with advanced EEG monitoring techniques to provide a decision support system for the anesthesiologist.

Read the detailed description

The balanced anesthesia process contains three main parts: the control of hypnosis, the analgesia and neuromuscular blockade. For the induction phase, the anesthesiologist performs protocols based on prior planning specific to each patient. Normally, the anesthesiologist controls the process by monitoring the classical vital signs and other clinical most common signs during the maintenance phase. In a way, this professional is the controller in a control system that acts on the plant (the patient) through the infusion of hypnotic and analgesic drugs and neuromuscular blockers.

In addition, the anesthesiologist estimates the the level of consciousness, of nociception and the level of neuromuscular blockade through these indirect measurements, just as a state observer in a control system would do.

There are different techniques for the direct monitoring of these three variables of anesthesia (DoA, NMB and NoL), such as BIS and Narcotrend, but all of them present a few disadvantages and mis-measurements, especially when the anesthesia process combines different drugs.

This work proposes a new way of evaluating DoA, NMB and NoL, using techniques to combine classical clinical signs with advanced EEG monitoring, to provide a decision support system for the anesthesiologist.

For this, we will perform data acquisition from the equipment usually used in surgical procedures with general anesthesia, such as ECG, EEG, blood pressure, mechanical ventilation, among others.

In short, all data of the patient's vital signs during the procedure and the actions taken by the anesthesiologist and surgeons.

The data will be concentrated on a specific equipment, and will be analyzed together with the data of other patients to improve the mathematical models involved in the process.

Conditions
Anesthesia
Keywords
General Anesthesia, Anesthesia Awareness, Anesthesia overdose
Medical subject headings
Intraoperative Awareness

What participants receive

What participants receive. In a randomised study each person is assigned to one group by chance.

Study groups in NCT04079036
Study groupRoleWhat they receive
Underweight Adult MaleMale patients with Underweight BMI classification and more than 20 years old https://www.cdc.gov/healthyweight/assessing/bmi/adult_bmi/index.html
Healthy Weight Adult MaleMale patients with Healthy Weight BMI classification and more than 20 years old
Overweight Adult MaleMale patients with OverWeight or Obese BMI classification and more than 20 years old
Underweight Adult FemaleFemale patients with Underweight BMI classification and more than 20 years old
Healthy Weight Adult FemaleFemale patients with Healthy Weight BMI classification and more than 20 years old
Overweight Adult FemaleFemale patients with Overweight or Obese BMI classification and more than 20 years old
Underweight children MaleMale patients less than 20 year old, and with Underweight BMI classification https://www.cdc.gov/healthyweight/assessing/bmi/childrens_bmi/about_childrens_bmi.html
Healthy Weight children MaleMale patients less than 20 year old, and with Healthy Weight BMI classification
Overweight children MaleMale patients less than 20 year old, and with Overweight or Obese BMI classification
Underweight children FemaleMale patients less than 20 year old, and with Underweight BMI classification https://www.cdc.gov/healthyweight/assessing/bmi/childrens_bmi/about_childrens_bmi.html
Healthy Weight children FemaleFemale patients less than 20 year old, and with Overweight or Obese BMI classification
Overweight children FemaleFemale patients less than 20 year old, and with Overweight or Obese BMI classification

What is being measured

The primary outcome is the main question the study is designed to answer.

  1. Heart Rate

    HR - Heart Rate - unit: [bpm], will be stored in real time during the surgical procedure.

    Measured: 2 to 3 months of different surgical procedures

  2. Arterial blood pressure

    P_INV - Invasive blood pressure - unit: [mmHg], will be stored in real time during the surgical procedure.

    Measured: 2 to 3 months of different surgical procedures

  3. Mean Arterial Pressure

    MAP - Mean Arterial Pressure - unit: [mmHg], will be stored in real time during the surgical procedure.

    Measured: 2 to 3 months of different surgical procedures

  4. Non Invasive Blood pressure

    P_NINV - Non Invasive blood pressure - unit: [mmHg/mmHg], will be stored in real time during the surgical procedure.

    Measured: 2 to 3 months of different surgical procedures

  5. Conscience Level

    CL - Consciousnesses Level (through BIS) - unit: [u 0-100] will be stored in real time during the surgical procedure.

    Measured: 2 to 3 months of diferent surgical procedures

  6. Inspired anesthetic concentration

    FiAA - Inspired fraction of anesthetic agent - unit: [% of Volume], will be stored in real time during the surgical procedure.

    Measured: 2 to 3 months of different surgical procedures

  7. Inspired carbon dioxide concentration

    FiCO2 - CO2 inspired Fraction - unit: [% of Volume], will be stored in real time during the surgical procedure.

    Measured: 2 to 3 months of different surgical procedures

  8. Inspired Nitrous Oxide concentration

    FiN2O - N2O inspired Fraction - unit: [% of Volume], will be stored in real time during the surgical procedure.

    Measured: 2 to 3 months of different surgical procedures

  9. Blood oxygen saturation

    SpO2 - Peripheral capillary oxygen saturation - unit: [%], will be stored in real time during the surgical procedure.

    Measured: 2 to 3 months of different surgical procedures

  10. Exhaled Carbon Dioxide concentration

    EtCO2 - End-tidal CO2 concentration (CO2 Exhaled Fraction) - unit: [% of Volume], will be stored in real time during the surgical procedure.

    Measured: 2 to 3 months of different surgical procedures

  11. Exhaled Anesthetic concentration

    EtAA - Anesthetic agents Exhaled Fraction - unit: [% of Volume], will be stored in real time during the surgical procedure.

    Measured: 2 to 3 months of different surgical procedures

  12. Anesthetic agent infusion rate

    IR_Anes - Infusion Rate of anesthetic agent - unit: [mg/hr], will be stored in real time during the surgical procedure.

    Measured: 2 to 3 months of different surgical procedures

  13. Analgesic agent infusion rate

    IR_Analg - Infusion rate of Analgesic agent - unit: [mg/hr], will be stored in real time during the surgical procedure.

    Measured: 2 to 3 months of different surgical procedures

  14. Neuro-muscular Block agent infusion rate

    IR_NMB - Infusion rate of neuro-muscular block agent - unit: [mg/hr], will be stored in real time during the surgical procedure.

    Measured: 2 to 3 months of different surgical procedures

  15. Ventilation respiratory rate

    RR - Respiratory Rate - unit: [bpm], will be stored in real time during the surgical procedure.

    Measured: 2 to 3 months of different surgical procedures

  16. Ventilation Tidal volume

    Vt - Tidal Volume - unit: [mL], will be stored in real time during the surgical procedure.

    Measured: 2 to 3 months of different surgical procedures

  17. Ventilation Minute Volume

    Vm - Minute Volume - unit: [L/min], will be stored in real time during the surgical procedure.

    Measured: 2 to 3 months of different surgical procedures

  18. Ventilation maximum pressure per cycle

    Pmax - Maximum pressure during the inspiration cycle - unit: [cmH2O], will be stored in real time during the surgical procedure.

    Measured: 2 to 3 months of different surgical procedures

  19. Ventilation Plateau pressure

    Pplateau - Plateau pressure during the inspiration cycle - unit: [cmH2O], will be stored in real time during the surgical procedure.

    Measured: 2 to 3 months of different surgical procedures

  20. Ventilation PEEP

    PEEP - Positive end of expiration pressure - unit: [cmH2O], will be stored in real time during the surgical procedure.

    Measured: 2 to 3 months of different surgical procedures

  21. Primary anesthesia Data - related to the manual infusion of drugs

    Every monitored clinical variable, related to the manual infusion of drugs, will be stored in real time during the surgical procedure.

    Every infusion made manually by the anesthesiologist during the procedure should be recorded, always considering the total amount infused and the time it occurred.

    Measured: 2 to 3 months of different surgical procedures

  22. Preoperative patient medical records - General state of the patient in ASA.

    Anesthesia related preoperative information from the patient, such as prior use of opioids, ASA and METS indexes.

    ASA - Physical state of the patient - unit: [u] P1 to P5

    Measured: 2 to 3 months of different surgical procedures

  23. Preoperative patient medical records - General state of the patient in METS.

    Anesthesia related preoperative information from the patient, such as prior use of opioids, ASA and METS indexes.

    METS - Functional state of the patient - unit: [u]

    Measured: 2 to 3 months of different surgical procedures

  24. Preoperative patient medical records - Clinical state of the patient - Age

    Anesthesia related preoperative information from the patient, such as:

    I - Age - unit: [years]

    Measured: 2 to 3 months of different surgical procedures

  25. Preoperative patient medical records - Clinical state of the patient - gender

    Anesthesia related preoperative information from the patient, such as:

    G - Gender - unit: Male or Female

    Measured: 2 to 3 months of different surgical procedures

  26. Preoperative patient medical records - Clinical state of the patient - Weight

    Anesthesia related preoperative information from the patient, such as:

    P - Weight - unit: [Kg]

    Measured: 2 to 3 months of different surgical procedures

  27. Preoperative patient medical records - Clinical state of the patient - Height

    Anesthesia related preoperative information from the patient, such as:

    A - Height - unit: [cm]

    Measured: 2 to 3 months of different surgical procedures

Timeline

From the start of the study to its completion; the mark is today. Estimated dates are the sponsor’s plan.

  1. First posted6 Sep 2019
  2. Study startOct 2019 (estimated)
  3. Primary completionDec 2019 (estimated)
  4. Study completionJan 2020 (estimated)

Resources

More details

For doctors and researchers: how the study is designed, who runs it, and its registry IDs.

Study design
Study type
Observational
Observational model
Case crossover
Time perspective
Prospective
Enrolment
360 participants (estimated)
Target duration
20 Days
IDs, dates and publications
ClinicalTrials.gov ID
NCT04079036
Sponsor's protocol ID
CAAE 03424918.6.0000.0068
Acronym
Serenity
Status last verified
Sep 2019
First submitted
10 Jul 2019
Last updated
6 Sep 2019
Results posted
No
Data monitoring committee
Yes
FDA-regulated drug
No
FDA-regulated device
No
Individual data sharing
Undecided

Publications

  • Schnider TW, Minto CF, Struys MM, Absalom AR. The Safety of Target-Controlled Infusions. Anesth Analg. 2016 Jan;122(1):79-85. doi: 10.1213/ANE.0000000000001005.

    PubMed 26516801
  • Karl J Åström, Björn Wittenmark. Computer-Controlled Systems: Theory and Design. Dover Books on Electrical Engineering. ISBN: 0486284042. Courier Corporation, 2013

  • Ahmad AM. Recent advances in pharmacokinetic modeling. Biopharm Drug Dispos. 2007 Apr;28(3):135-43. doi: 10.1002/bdd.540.

    PubMed 17295411
  • Iselin-Chaves IA, Flaishon R, Sebel PS, Howell S, Gan TJ, Sigl J, Ginsberg B, Glass PS. The effect of the interaction of propofol and alfentanil on recall, loss of consciousness, and the Bispectral Index. Anesth Analg. 1998 Oct;87(4):949-55. doi: 10.1097/00000539-199810000-00038.

    PubMed 9768800

Questions about this trial

What is this clinical trial studying?

An observational study of Anesthesia, run by University of Sao Paulo General Hospital at 1 site in Brazil.

The full registered description is in the About this study section and the official record.

Who may be eligible to take part?

The sponsor lists 1 inclusion and 1 exclusion criteria. Eligibility is decided by the study team after screening, so read the full criteria and contact a listed site.

Is this clinical trial currently recruiting?

The record says: status not confirmed, as of the sponsor's last update on 6 Sep 2019. Status can change between updates, so confirm with the study contact before making plans.

Where is the study taking place?

The record lists 1 site in Brazil. Whether a site is taking part right now should be confirmed with that site. See every site.

What are the possible benefits and risks?

They depend on the study and the treatment, and no study can promise a benefit. The study team explains the known risks during informed consent, before anyone joins; the record itself does not list them.

Are results available for this study?

Results are not available in the source record.

How can a doctor refer a patient or contact the research team?

Contact Bruno B Turrin, Msc (+5511998745879, bbturrin@usp.br), or a site near the patient. AzTrials does not enrol participants or take referrals.

What does the primary outcome measure?

Heart Rate (time frame: 2 to 3 months of different surgical procedures). The study lists 27 primary outcomes in all. It is what the study was designed to measure, not a finding.

Where can I read the original study information?

On the ClinicalTrials.gov record for NCT04079036, which also lists 4 linked publications.

Does a listing mean the treatment is approved or proven to work?

No. A listing means the study is registered. It does not show that the treatment is safe, works, or is approved by a regulator.

How often is this information updated?

AzTrials copies changed records from ClinicalTrials.gov every night and reloads the whole registry every week. The sponsor last updated this record on 6 Sep 2019; AzTrials last refreshed its copy on 27 Oct 2026.

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