Effect of Sevoflurane-induced Postconditioning on the Incidence of Postoperative Cerebral Hyperperfusion Syndrome After Revascularization Surgery in Adult Patients With Moyamoya Disease
Overview
- Phase
- Not Applicable
- Intervention
- Sevoflurane
- Conditions
- Hyperperfusion Syndrome
- Sponsor
- Seoul National University Hospital
- Enrollment
- 152
- Primary Endpoint
- The incidence of postoperative cerebral hyperperfusion syndrome
- Last Updated
- 10 years ago
Overview
Brief Summary
The aim of the present study is to evaluate the effect of sevoflurane postconditioning on the incidence of postoperative hyperperfusion syndrome following revascularization surgery in moyamoya patients.
Detailed Description
Postoperative hyperperfusion syndrome is a common complication in moyamoya disease patients receiving revascularization surgery. Previously its incidence has been reported to be 17\~50%, but little remains regarding frequency of reperfusion injury after revascularization surgery in patients with moyamoya disease. Volatile anesthetics such as sevoflurane has been introduced clinically to reduce reperfusion injury and preconditioning with sevoflurane induced ischemic tolerance like as ischemic preconditioning. However, there was no report on the neuroprotective effect of sevoflurane postconditioning on ischemic/reperfusion injury in human brain. Therefore, We evaluated the neuroprotective effect of sevoflurane postconditioning on the incidence of postoperative hyperperfusion syndrome after revascularization surgery in moyamoya disease patients.
Investigators
Hee-Pyoung Park
Associate Professor
Seoul National University Hospital
Eligibility Criteria
Inclusion Criteria
- •Adult patients receiving cerebral revascularization surgery due to moyamoya disease
Exclusion Criteria
- •Patients who do not agree to the study
- •Patients with uncontrolled diabetes or hypertension
- •Patients using cyclooxygenase2 inhibitor or with previously using cyclooxygenase2 inhibitor
- •Patients with acute renal failure
- •Patients with previous intervention related with moyamoya disease
Arms & Interventions
Sevo_postconditioning
Patients receiving sevoflurane 1.0 minimum alveolar concentration (MAC) for 30 minutes after revascularization competed.
Intervention: Sevoflurane
Outcomes
Primary Outcomes
The incidence of postoperative cerebral hyperperfusion syndrome
Time Frame: postoperative day 15
Cerebral hyperperfusion syndrome was defined if all the following four criteria were met: i) new development of postoperative focal neurological deficits, ii) a delayed neurological deficits which were not shown in the immediate postoperative period; iii) postoperative reversible neurological deficits which were completely resolved within 15 days after operation; iii) neither definite haematomas nor definite acute infarction on a brain CT scan, on diffusion magnetic resonance imaging, or both.
Secondary Outcomes
- The incidence of a new onset postoperative cerebral ischemia(participants will be followed for the duration of hospital stay, an expected average of 3 weeks.)
- The incidence of a new onset postoperative brain hematoma(participants will be followed for the duration of hospital stay, an expected average of 3 weeks.)
- The incidence of unrecovered neurological deficit(participants will be followed for the duration of hospital stay, an expected average of 3 weeks.)