The Effect of Total Intravenous Anesthesia and Volatile Anesthesia on Shedding of the Endothelial Glycocalyx in Patients Undergoing Laparoscopic or Robotic Assisted Gastrectomy
Overview
- Phase
- Not Applicable
- Intervention
- propofol
- Conditions
- Gastrostomy
- Sponsor
- Yonsei University
- Enrollment
- 136
- Locations
- 1
- Primary Endpoint
- Changes in blood concentration of syndecan-1
- Status
- Completed
- Last Updated
- 5 years ago
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 before and after laparoscopic or robotic assisted gastrectomy.
Detailed Description
A commercial TIVA(Total Intravenous Anesthesia and Volatile Anesthesia ) pump was used for target-controlled infusion (TCI) of remifentanil and propofol. In the volatile group, anesthesia was induced with an intravenous bolus of propofol 1.5-2 mg/kg and TCI of remifentanil (effect-site concentration \[Ce\] of 4.0 ng/ml). 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). In the volatile group, anesthesia was maintained with sevoflurane (0.8-1 age-adjusted minimum alveolar concentration \[MAC\]) and TCI of remifentanil, while in the TIVA group, anesthesia was maintained with TCI of propofol and remifentanil. Anesthesia depth was adjusted to maintain a PSI(Patient State Index) of 25-50. Endotracheal intubation was performed after administration of intravenous rocuronium 1.2 mg/kg and neuromuscular blockade depth was maintained to a target of train-of-four of 0-2 with infusion of rocuronium during pneumoperitoneum.
Investigators
Eligibility Criteria
Inclusion Criteria
- •Adult patients over 20 years old with ASA class I-III
- •Scheduled laparoscopic or robotic assisted laparoscopic gastrectomy
Exclusion Criteria
- •emergency surgery
- •patients unable to make their own decisions, illiterate, foreigners
- •Allergy / hypersensitivity to sevoflurane or propofol 4, 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(Total Intravenous Anesthesia and Volatile Anesthesia )
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
Inhalation
Arm Description: In the volatile group, anesthesia was induced with an intravenous bolus of propofol 1.5-2 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
Outcomes
Primary Outcomes
Changes in blood concentration of syndecan-1
Time Frame: 1 day after surgery
Blood levels of syndecan-1 are assessed 1 day after surgery.