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Cardiac AnesthesiaNCT05320341

TIVA Versus Inhalational Anesthesia and Tissue Oxygenation in Cardiac Surgery

An observational study of Cardiac Anesthesia, run by Ankara City Hospital Bilkent at 1 site in Turkey (Türkiye).

Completed

Finished. The study has ended and is not enrolling. Results may be posted on the official record.

Official record
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Trial summary

The aim of this study was to evaluate the effect of total intravenous anesthesia (TIVA) and inhalational anesthesia techniques on tissue oxygenation in cardiac surgery. The primary objective of this study was to compare the effects of midazolam-based TIVA and sevoflurane-based (SEVO) inhalation anesthesia maintenance… Read more about this study

Who is it for?
Ages 18 years and older
Conditions the study is for
Cardiac Anesthesia
What is being tested?
TIVA and SEVO
Type of treatment
Surgery or procedure
How many people
104 participants
Where
1 siteTurkey (Türkiye)
Study dates
1 Feb 2019to 1 Mar 2021
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 18 years and older
  • All sexes
  • No healthy volunteers
  • Adult, Older adult

Study population: adult patients who undergoing coronary surgeries with cardiopulmonary bypass

Who may be able to join

  • coronary surgeries with CPB

Who cannot join

  • emergency surgeries,
  • operations
  • ejection fraction under 40%
  • coronary surgeries in conjunction with other procedures
  • cerebrovascular accident
  • neurological disorders
  • hematologic disorder
  • chronic alcohol use

Trial locations and contacts

1 site in 1 country.

Turkey (Türkiye)1 site
  • Ankara City Hospital

    Ankara, Select State/Province, 06800

Other trials in Turkey (Türkiye)

About this study

Official title: The Effects of Total Intravenous and Inhalation Anesthesia Maintenance on Tissue Oxygenation in Coronary Artery Bypass Graft Surgery

The aim of this study was to evaluate the effect of total intravenous anesthesia (TIVA) and inhalational anesthesia techniques on tissue oxygenation in cardiac surgery. The primary objective of this study was to compare the effects of midazolam-based TIVA and sevoflurane-based (SEVO) inhalation anesthesia maintenance on intraoperative central and regional tissue oxygenation parameters.

Read the detailed description

A pressing issue in anesthesiology involves developing an understanding of the non-anesthetic effects of the medications typically used in intravenous and inhalation anesthesia methods. Few studies describe the effects of both intravenous and inhalational anesthetics on regional tissue perfusion is described under stable anesthetic conditions. There is the issue of whether inhalational anesthetics compromise regional tissue perfusion even though systemic parameters are within normal ranges. It is still debated how these effects may be different under pathophysiological conditions, such as cardiac surgery.

Maintaining tissue perfusion and oxygenation is the cornerstone of therapy for patients with cardiac disease. An imbalance in oxygen delivery and tissue oxygen consumption leads to anaerobic metabolism, cellular injury, and organ dysfunction, and is associated with poor outcomes. Consequently, monitoring tissue oxygen delivery and consumption status is of paramount importance in cardiac surgery patients. Routinely used monitors in intraoperative settings such as pulse oximetry, blood pressures, hemoglobin saturation levels, lactate, acid-base status, and central venous oxygen saturation levels all reflect tissue metabolism. Near-infrared spectroscopy (NIRS) is a non-invasive optical technique that can be used to continuously monitor tissue oxygen delivery and oxygen consumption status. Cerebral autoregulation can blunt the effect of impaired systemic oxygen delivery. Thus, cerebral NIRS may be a good predictor of neurological outcomes, but skeletal muscle NIRS serves as a follow-up indicator of many other postoperative complications due to impaired perfusion and oxygenation. Therefore, both cerebral and somatic monitoring may contribute to a more complete evaluation of hemodynamic competence. Obtaining the cerebral and somatic oxygenation levels are valuable to help in clinical management during cardiopulmonary bypass (CPB) and cardiac surgery as a whole.

The aim of this study was to evaluate the effect of total intravenous anesthesia (TIVA) and inhalational anesthesia techniques on tissue oxygenation in cardiac surgery. For this purpose, the effects of midazolam-based TIVA or sevoflurane-based inhalation anesthesia maintenance on intraoperative central and somatic tissue oxygenation parameters were compared in patients undergoing cardiac surgery.

Being tested
TIVA, SEVO
Keywords
tissue oxygenation, total intravenous anesthesia, inhalational anesthesia, cardiac surgery, NIRS

What participants receive

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

  • TIVAProcedure or surgery

    During the anesthesia maintenance of the TIVA group, 3 μg.kg-1 fentanyl, 0.01-0.05 mg.kg-1 midazolam, and 0.2 mg.kg-1 rocuronium bromide were applied throughout the operation to keep BIS between 40 and 60, approximately once every 45 minutes.

  • SEVOProcedure or surgery

    During the anesthesia maintenance of the SEVO group, 2-3% sevoflurane (1-2 MAC), 3 μg.kg-1 fentanyl and 0.2 mg.kg-1 rocuronium bromide were applied throughout the operation to keep BIS between 40-60.

Study groups in NCT05320341
Study groupRoleWhat they receive
TIVA groupDuring the anesthesia maintenance of the TIVA group, 3 μg.kg-1 fentanyl, 0.01-0.05 mg.kg-1 midazolam, and 0.2 mg.kg-1 rocuronium bromide were applied throughout the operation to keep BIS between 40 and 60, approximately once every 45 minutes.
Receives: Procedure: TIVA
SEVO groupDuring the anesthesia maintenance of the SEVO group, 2-3% sevoflurane (1-2 MAC), 3 μg.kg-1 fentanyl and 0.2 mg.kg-1 rocuronium bromide were applied throughout the operation to keep BIS between 40-60.
Receives: Procedure: SEVO

What is being measured

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

  1. Hemodynamic parameters

    mean arterial pressure in mmHg was recorded

    Measured: 5 minutes after anesthesia induction

  2. Hemodynamic parameters

    heart rate (beat per minute) were recorded

    Measured: 5 minutes after anesthesia induction

  3. Hemodynamic parameters

    mean arterial pressure (mmHg) was recorded

    Measured: After cardiopulmonary bypass cannulation, an average of 5 minutes

  4. Hemodynamic parameters

    heart rate (beat per minute) was recorded

    Measured: After cardiopulmonary bypass cannulation, an average of 5 minutes

  5. Hemodynamic parameters

    mean arterial pressure (mmHg) was recorded

    Measured: 10th minute of cardiopulmonary bypass

  6. Hemodynamic parameters

    heart rate (beat per minute) was recorded

    Measured: 10th minute of cardiopulmonary bypass

  7. Hemodynamic parameters

    mean arterial pressure (mmHg) was recorded

    Measured: 10 minutes after cross clamp removal

  8. Hemodynamic parameters

    heart rate (beat per minute) was recorded

    Measured: 10 minutes after cross clamp removal

  9. Hemodynamic parameters

    mean arterial pressure (mmHg) was recorded

    Measured: 10 minutes after CPB completion

  10. Hemodynamic parameters

    heart rate (beat per minute ) was recorded

    Measured: 10 minutes after CPB completion

  11. Hemodynamic parameters

    mean arterial pressure (mmHg) was recorded

    Measured: upon sternum closing

  12. Hemodynamic parameters

    heart rate (beat per minute) was recorded

    Measured: upon sternum closing

  13. Arterial gas sampling

    pH levels were recorded

    Measured: 5 minutes after anesthesia induction

  14. Arterial gas sampling

    central venous saturation (%) levels were recorded

    Measured: 5 minutes after anesthesia induction

  15. Arterial gas sampling

    lactate levels (mmol/L) were recorded

    Measured: 5 minutes after anesthesia induction

  16. Arterial gas sampling

    Hemoglobin (g/dL) levels were recorded

    Measured: 5 minutes after anesthesia induction

  17. Arterial gas sampling

    pH levels were recorded

    Measured: After cardiopulmonary bypass cannulation, an average of 5 minutes

  18. Arterial gas sampling

    central venous saturation (%) levels were recorded

    Measured: After cardiopulmonary bypass cannulation, an average of 5 minutes

  19. Arterial gas sampling

    lactate (mmol/L) levels were recorded

    Measured: After cardiopulmonary bypass cannulation, an average of 5 minutes

  20. Arterial gas sampling

    hemoglobin (g/dL)levels were recorded

    Measured: After cardiopulmonary bypass cannulation, an average of 5 minutes

  21. Arterial gas sampling

    pH levels were recorded

    Measured: 10th minute of cardiopulmonary bypass

  22. Arterial gas sampling

    central venous saturation (%) levels were recorded

    Measured: 10th minute of cardiopulmonary bypass

  23. Arterial gas sampling

    lactate (mmol/L) levels were recorded

    Measured: 10th minute of cardiopulmonary bypass

  24. Arterial gas sampling

    hemoglobin (g/dL) levels were recorded

    Measured: 10th minute of cardiopulmonary bypass

  25. Arterial gas sampling

    pH levels were recorded

    Measured: 10 minutes after cross clamp removal

  26. Arterial gas sampling

    central venous saturation (%) levels were recorded

    Measured: 10 minutes after cross clamp removal

  27. Arterial gas sampling

    lactate (mmol/L) levels were recorded

    Measured: 10 minutes after cross clamp removal

  28. Arterial gas sampling

    hemoglobin (g/dL) levels were recorded

    Measured: 10 minutes after cross clamp removal

  29. Arterial gas sampling

    pH levels were recorded

    Measured: 10 minutes after CPB completion

  30. Arterial gas sampling

    central venous saturation (%) levels were recorded

    Measured: 10 minutes after CPB completion

  31. Arterial gas sampling

    lactate (mmol/L) levels were recorded

    Measured: 10 minutes after CPB completion

  32. Arterial gas sampling

    hemoglobin (g/dL) levels were recorded

    Measured: 10 minutes after CPB completion

  33. Arterial gas sampling

    pH levels were recorded

    Measured: upon sternum closing

  34. Arterial gas sampling

    central venous saturation (%) levels were recorded

    Measured: upon sternum closing

  35. Arterial gas sampling

    lactate (mmol/L) levels were recorded

    Measured: upon sternum closing

  36. Arterial gas sampling

    hemoglobin (g/dL) levels were recorded

    Measured: upon sternum closing

  37. NIRS

    cerebral (rSO2) values were recorded

    Measured: 5 minutes after anesthesia induction

  38. NIRS

    somatic (rSO2) values were recorded

    Measured: 5 minutes after anesthesia induction

  39. NIRS

    cerebral (rSO2) values were recorded

    Measured: After cardiopulmonary bypass cannulation, an average of 5 minutes

  40. NIRS

    somatic(rSO2) values were recorded

    Measured: After cardiopulmonary bypass cannulation, an average of 5 minutes

  41. NIRS

    cerebral (rSO2) values were recorded

    Measured: 10th minute of cardiopulmonary bypass

  42. NIRS

    somatic (rSO2) values were recorded

    Measured: 10th minute of cardiopulmonary bypass

  43. NIRS

    cerebral (rSO2) were recorded

    Measured: 10 minutes after cross clamp removal

  44. NIRS

    somatic (rSO2) were recorded

    Measured: 10 minutes after cross clamp removal

  45. NIRS

    cerebral(rSO2)values were recorded

    Measured: 10 minutes after CPB completion

  46. NIRS

    somatic (rSO2) values were recorded

    Measured: 10 minutes after CPB completion

  47. NIRS

    cerebral(rSO2)values were recorded

    Measured: upon sternum closing

  48. NIRS

    somatic (rSO2) values were recorded

    Measured: upon sternum closing

Timeline

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

  1. First posted11 Apr 2022
  2. Study start1 Feb 2019
  3. Primary completion1 Nov 2020
  4. Study completion1 Mar 2021

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-control
Time perspective
Prospective
Enrolment
104 participants (actual)
IDs, dates and publications
ClinicalTrials.gov ID
NCT05320341
Sponsor's protocol ID
MH.2.5
Status last verified
Apr 2022
First submitted
23 Mar 2022
Last updated
11 Apr 2022
Results posted
No
Data monitoring committee
No
FDA-regulated drug
No
FDA-regulated device
No
Individual data sharing
Undecided

Publications

  • Turek Z, Sykora R, Matejovic M, Cerny V. Anesthesia and the microcirculation. Semin Cardiothorac Vasc Anesth. 2009 Dec;13(4):249-58. doi: 10.1177/1089253209353134. Epub 2009 Dec 2.

    PubMed 19959497
  • Bickler P, Feiner J, Rollins M, Meng L. Tissue Oximetry and Clinical Outcomes. Anesth Analg. 2017 Jan;124(1):72-82. doi: 10.1213/ANE.0000000000001348.

    PubMed 27308951
  • De Backer D, Dubois MJ, Schmartz D, Koch M, Ducart A, Barvais L, Vincent JL. Microcirculatory alterations in cardiac surgery: effects of cardiopulmonary bypass and anesthesia. Ann Thorac Surg. 2009 Nov;88(5):1396-403. doi: 10.1016/j.athoracsur.2009.07.002.

    PubMed 19853081

Questions about this trial

What is this clinical trial studying?

An observational study of Cardiac Anesthesia, run by Ankara City Hospital Bilkent at 1 site in Turkey (Türkiye).

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 8 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: finished, as of the sponsor's last update on 11 Apr 2022. 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 Turkey (Türkiye). 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?

The study is completed, but results are not available in the source record. That does not mean the treatment did or did not work.

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

The record lists no contact. The official record names the sponsor, who can be asked directly. AzTrials does not enrol participants or take referrals.

What does the primary outcome measure?

Hemodynamic parameters (time frame: 5 minutes after anesthesia induction). The study lists 48 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 NCT05320341, which also lists 3 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 11 Apr 2022.

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