Desflurane and Brain Relaxation in Craniotomy
- Registration Number
- NCT04691128
- Lead Sponsor
- Beijing Tiantan Hospital
- Brief Summary
Optional brain relaxation improves the surgeon's operating conditions and is likely to minimize the degree of retraction injury ,with the potential for providing patients with a better outcome. The choice of anesthetic drugs can affect intraoperative brain relaxation. Propofol suppresses brain metabolism, reduces cerebral blood flow, and provides satisfactory brain relaxation. Desflurane is often criticized in neurosurgery due to its cerebral vasodilation and potential to increase intracranial pressure, however, it has been found to have a little clinical significance. This study intends to compare the effects of desflurane with propofol on brain relaxation in patients with supratentorial tumors under mild hyperventilation, and to provide new clinical evidence for the use of desflurane in neurosurgical anesthesia.
- Detailed Description
To compare the effect of desflurane versus propofol combined with remifentanil anesthesia on brain relaxation in patients undergoing supratentorial tumor surgery with mild hyperventilation, and compare the emergence time and common complications during recovery.
Recruitment & Eligibility
- Status
- COMPLETED
- Sex
- All
- Target Recruitment
- 111
- 18-60 years
- Scheduled for elective craniotomy for supratentorial cerebral tumors
- ASA status I-III
- Glasgow score of 15
- No clinical signs of intracranial hypertension
- Preoperative brain imaging (CT or MRI) with midline shift less than 5mm
- Informed consent signed by patients
- Scheduled intraoperative motor evoked potential monitoring
- Patients with cerebral vascular diseases
- Uncontrolled cardiopulmonary disease
- Schedule to retain tracheal intubation after surgery
- Unable to comprehend and cooperate with the examination
- BMI > 30 Kg/m-2
- Emergency surgery
- History of related anesthetic allergy
Study & Design
- Study Type
- INTERVENTIONAL
- Study Design
- PARALLEL
- Arm && Interventions
Group Intervention Description Desflurane inhalational anesthesia Desflurane - Propofol total intravenous anesthesia Propofol -
- Primary Outcome Measures
Name Time Method Proportion of satisfactory brain relaxation during surgery Assessed by the neurosurgeon using a 4-point scale (1= perfectly relaxed, 2= satisfactorily relaxed, 3= firm brain, 4=bulging brain) at the opening of the dura mater, score 1 and 2 represent satisfactory brain relaxation
- Secondary Outcome Measures
Name Time Method Dural tension during surgery evaluated using a 4-point scale after bone flap removal.
Quality of anesthesia recovery at postoperative day 1 assessed by quality of recovery-15 scale (QoR-15)
Early postanesthesia cognitive recovery at 15, 30min after tracheal extubation evaluated by Short Orientation Memory Concentration Test (SOMCT)
Emergence time from drug discontinuation to eye opening, assessed up to 1 hours from drug discontinuation to eye opening
Postoperative complications from drug discontinuation to discharge from PACU (Postanesthesia care unit), assessed up to 3 hours incidence of hypoxemia, hypotension, hypertension, tachycardia, bradycardia, agitation, shivering.
Duration in PACU (Postanesthesia care unit) from entering PACU to exiting PACU, an expected average of 1 hour time from entering PACU to exiting PACU
Anesthesia expenses at postoperative day 1 Total cost of anesthesia
Extubation time from drug discontinuation to tracheal extubation, assessed up to 1 hours from drug discontinuation to tracheal extubation
Postoperative pain and postoperative nausea and vomiting (PONV) during the PACU stay and postoperative day 1. evaluated by Visual Analogue Score(VAS).
Trial Locations
- Locations (1)
Beijing Tiantan Hospital, Capital Medical University
🇨🇳Beijing, Beijing, China