The Effect of a Narcotic Free Total Intravenous Anesthesia on the Outcome and Patient Safety During Anterior Cervical Discectomy and Fusion (ACDF) Surgery: A Randomized Controlled Trial
Overview
- Phase
- Phase 4
- Intervention
- Remifentanil
- Conditions
- Anterior Cervical Discectomy and Fusion (ACDF)
- Sponsor
- University of Arkansas
- Enrollment
- 32
- Locations
- 1
- Primary Endpoint
- Incidence of Unacceptable Movement Under General Anesthesia
- Status
- Completed
- Last Updated
- 2 years ago
Overview
Brief Summary
This study will help the investigators learn more about the best way to give anesthesia for these kinds of surgery. The investigators will be using 2 different groups of medications that is commonly used in ACDF surgery, one group has a Narcotic, and the other group does not. The investigators wish to test whether a narcotic free anesthetic will result in an overall safer surgery, better patient recovery, and satisfaction. The investigators think also that eliminating the Narcotic from the Anesthetic regimen will allow patients to recover faster after surgery , and consume less pain medicines in the postoperative period.
Investigators
Eligibility Criteria
Inclusion Criteria
- Not provided
Exclusion Criteria
- Not provided
Arms & Interventions
Remifentanil Group
Remifentanil infusion of 0.05 to 0.2 mcg/kg/minute started just prior to induction and stopped at emergence from anesthesia.
Intervention: Remifentanil
Ketamine and Dexmedetomidine group
dexmedetomidine bolus of 0.5 mcg/kg over 10 minutes starting 5 minutes prior to induction followed by an infusion of 0.2-0.7 mcg/kg/hour that will be stopped with the start of closing the surgical wound. Ketamine infusion of 2 mcg/kg/minute will be started at induction. It will be stopped at the beginning of the emergence from anesthesia, roughly 45 minutes from extubation.
Intervention: Ketamine
Ketamine and Dexmedetomidine group
dexmedetomidine bolus of 0.5 mcg/kg over 10 minutes starting 5 minutes prior to induction followed by an infusion of 0.2-0.7 mcg/kg/hour that will be stopped with the start of closing the surgical wound. Ketamine infusion of 2 mcg/kg/minute will be started at induction. It will be stopped at the beginning of the emergence from anesthesia, roughly 45 minutes from extubation.
Intervention: Dexmedetomidine
Outcomes
Primary Outcomes
Incidence of Unacceptable Movement Under General Anesthesia
Time Frame: duration of surgery
Gross visible movement reported by the anesthesiologist or surgical team: bucking, chewing, or reaching to the endotracheal tube and induced by nociception, or head manipulation and positioning by the surgical or anesthesiology team or during a motor evoked potential stimulation.
Secondary Outcomes
- Hemodynamic Stability(up to 24 hours)
- Time to Extubation(up to 24 hours)
- Narcotic Consumption(24 hours)
- Quality of Recovery(24 hours post-op)