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Effect of Dexmedetomidine on Quality of Recovery in Non-functioning Pituitary Adenoma Patients Undergoing Endoscopic Transsphenoidal Surgery

Phase 2
Conditions
Non-functioning Pituitary Adenoma
Interventions
Drug: normal saline
Registration Number
NCT05005715
Lead Sponsor
Seoul National University Hospital
Brief Summary

In multiple previous studies that have explored the use of dexmedetomidine in transsphenoidal tumor resection surgery, dexmedetomidine showed many beneficial effects like reducing the requirement of analgesics and anesthetics, improving hemodynamic stability and decreasing the emergence time, extubation time and visual analog scale at emergence. Therefore, the investigators hypothesized that dexmedetomidine would decrease neuroendocrine stress response and improve the quality of postoperative recovery.

Detailed Description

Not available

Recruitment & Eligibility

Status
UNKNOWN
Sex
All
Target Recruitment
64
Inclusion Criteria
  • Non-functioning patients undergoing endoscopic transsphenoidal tumor surgery under general anesthesia
Exclusion Criteria
  • Patients who do not agree to participate in the study
  • Patients with contraindication to dexmedetomidine
  • Patients with previous history of endoscopic transsphenoidal tumor surgery
  • Patients who take anticoagulants or have bleeding disorder
  • Patients with conduction block or cardiovascular disease
  • Patients with psychiatric disease such as dementia, delirium
  • Patients have difficulty filling out the QoR-15 questionnaire
  • Pregnant or lactating women
  • Patients who have allergies to propofol, remifentanil, fentanyl or rocuronium
  • Patients with myasthenia gravis or myasthenic syndrome

Study & Design

Study Type
INTERVENTIONAL
Study Design
PARALLEL
Arm && Interventions
GroupInterventionDescription
Control groupnormal salineAfter the induction of anesthesia, the control group received intravenous normal saline at the same loading volume for 10 min, followed by the same volume until the end of surgery.
Dexmedetomidine groupDexmedetomidineAfter the induction of anesthesia, the dexmedetomidine group received intravenous dexmedetomidine at a loading dose of 1µg/kg for 10 min, followed by a maintenance dose of 0.5µg/kg/h until the end of surgery.
Primary Outcome Measures
NameTimeMethod
Quality of recovery-15 (QoR-15) scorepostoperative day 1

Self-rated questionnaire composed of 15 items (each item: 0-10 points, total: 0-150 points) of five dimensions: physical well-being, physical independence, emotional state, psychological support, and pain. Higher scores indicate better quality of recovery.

Secondary Outcome Measures
NameTimeMethod
Serum level of cortisolpreoperative (1-2 month before surgery), intraoperative (when surgeon starts tumor resection), immediately postoperative (30 min after the end of surgery)

ug/dL

Serum level of triiodothyronine (T3)preoperative (1-2 month before surgery), intraoperative (when surgeon starts tumor resection), immediately postoperative (30 min after the end of surgery)

ng/dL

Pain score (visual analogue scale, VAS)postoperative 4 hour, 1 day, 2 day

Self-reported measures of symptoms that are recorded with a single handwritten mark placed at one point along the length of a 10-cm line that represents a continuum between the two ends of the scale-"no pain" on the left end (0 cm) of the scale and the "worst pain" on the right end of the scale (10 cm).

Serum level of triiodothyronine (T4)preoperative (1-2 month before surgery), intraoperative (when surgeon starts tumor resection), immediately postoperative (30 min after the end of surgery)

ng/dL

Serum level of thyroid stimulating hormone (TSH)preoperative (1-2 month before surgery), intraoperative (when surgeon starts tumor resection), immediately postoperative (30 min after the end of surgery)

uIU/mL

Incidence and severity of postoperative complicationspostoperative (up to 2 weeks after surgery)

nausea, vomiting, etc.

Serum level of luteinizing hormone (LH)preoperative (1-2 month before surgery), intraoperative (when surgeon starts tumor resection), immediately postoperative (30 min after the end of surgery)

mIU/mL

Serum level of follicle stimulating hormone (FSH)preoperative (1-2 month before surgery), intraoperative (when surgeon starts tumor resection), immediately postoperative (30 min after the end of surgery)

mIU/mL

Serum level of adredocorticotrophic hormone (ACTH)preoperative (1-2 month before surgery), intraoperative (when surgeon starts tumor resection), immediately postoperative (30 min after the end of surgery)

pg/mL

Time to the first administration of rescue analgesics after the end of surgerypostoperative (up to 2 weeks after surgery)
Total amounts of propofol and remifentanil administered during surgeryintraoperative (from induction of anesthesia until end of anesthesia)
Serum level of prolactinpreoperative (1-2 month before surgery), intraoperative (when surgeon starts tumor resection), immediately postoperative (30 min after the end of surgery)

ng/mL

Time to emergence after the end of surgerypostoperative (up to 1 day after surgery)
Hospital length of staypostoperative (up to 2 weeks after surgery)
Serum level of growth hormone (GH)preoperative (1-2 month before surgery), intraoperative (when surgeon starts tumor resection), immediately postoperative (30 min after the end of surgery)

ng/mL

Serum level of insulin-like growth factor-1 (IGF-1)preoperative (1-2 month before surgery), intraoperative (when surgeon starts tumor resection), immediately postoperative (30 min after the end of surgery)

ng/mL

Serum level of antidiuretic hormone (ADH)preoperative (1-2 month before surgery), intraoperative (when surgeon starts tumor resection), immediately postoperative (30 min after the end of surgery)

pg/ml

Total amounts of rescue analgesicspostoperative (up to 2 weeks after surgery)
Time to extubation after the end of surgerypostoperative (up to 1 day after surgery)

Trial Locations

Locations (1)

Seoul National University Hospital

🇰🇷

Seoul, Korea, Republic of

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