The Effect of Volatile Anesthesia and Total Intravenous Anesthesia on Shedding of the Endothelial Glycocalyx in Patients Undergoing Mastectomy and Breast Reconstruction Using Deep Inferior Epigastric Artery Perforator Free Flap
Trial Snapshot
- Phase
- Not Applicable
- Status
- Completed
- Sponsor
- Yonsei University
- Enrollment
- 50
- Locations
- 1
- Primary Endpoint
- Changes in blood concentration of syndecan-1
Study Overview
Brief Summary
The aim of this study was to investigate the effects of total intravenous and inhalation anesthesia on the damage of endothelial glucocorticoids by comparing the concentration of syndecan-1 in patients undergoing mastectomy and breast reconstruction using deep inferior epigastric artery perforator free flap
Detailed Description
The aim of this study was to investigate the effects of total intravenous and inhalation anesthesia on the damage of endothelial glucocorticoids by comparing the concentration of syndecan-1 in patients undergoing mastectomy and breast reconstruction using deep inferior epigastric artery perforator free flap
Study Design
- Study Type
- Interventional
- Allocation
- Randomized
- Intervention Model
- Parallel
- Primary Purpose
- Prevention
- Masking
- None
Eligibility Criteria
- Ages
- 20 Years to — (Adult, Older Adult)
- Sex
- Female
- Accepts Healthy Volunteers
- No
Inclusion Criteria
- •Adult patients over 20 years old with ASA class I-III
- •Scheduled total mastectomy and deep inferior epigastric artery perforator flap breast reconstruction
Exclusion Criteria
- •emergency surgery
- •Bilateral deep inferior epigastric artery perforator flap breast reconstruction
- •patients unable to make their own decisions, illiterate, foreigners
- •Allergy / hypersensitivity to sevoflurane or propofol 5, Current or past history or thrombosis / thromboembolism
- •patients who are taking oral contraceptives
- •Patients with renal insufficiency (eGFR 60 ml / min / 1.73 m 2 or less)
- •Patients receiving anticoagulants
- •pregnant and lactating women
- •Patients with history of psychiatric disease or neurological disease
Arms & Interventions
TIVA
In the TIVA group, anesthesia was induced with TCI of propofol (Ce of 4.0-4.5 μg/ml) and remifentanil (Ce of 4.0 ng/ml). Anesthesia was maintained with TCI of propofol and remifentanil. Anesthesia depth was adjusted to maintain a PSI of 25-50.
Intervention: Propofol (Drug)
Inhalation
In the volatile group, anesthesia was induced with an intravenous bolus of propofol 1.0-1.5 mg/kg and TCI of remifentanil (effect-site concentration [Ce] of 4.0 ng/ml). Anesthesia was maintained with sevoflurane (0.8-1 age-adjusted minimum alveolar concentration) and TCI of remifentanil
Intervention: Sevoflurane (Drug)
Outcomes
Primary Outcomes
Changes in blood concentration of syndecan-1
Time Frame: 1) 10 minutes after anesthesia induction <before surgery(base concentration)> 2) 10 minutes after sitting position 3) 1 hour after surgery
Blood levels of syndecan-1 are assessed at 10 minutes after anesthesia induction, 10 minutes after sitting position, and 1 hour after surgery.
Secondary Outcomes
No secondary outcomes reported