The Effect of the Anticholinergic Burden Following Elective Coronary Artery Surgery
- Conditions
- MortalityPostoperative Complications
- Interventions
- Drug: reducing anticholinergic burden
- Registration Number
- NCT06349057
- Lead Sponsor
- Ankara City Hospital Bilkent
- Brief Summary
Many drugs have anticholinergic activity. This means that it blocks the muscarinic binding of the neurotransmitter acetylcholine.
In this study, the anticholinergic burden of the patients in the perioperative period will be calculated with the Anticholinergic Cognitive Burden Scale (ACBS) and patients with a score of 1 or above will be included in the study. Anticholinergic load of drugs used in the intraoperative period; Its effect on postoperative hospital stay, morbidity and mortality following elective heart surgery will be investigated.
- Detailed Description
Not available
Recruitment & Eligibility
- Status
- COMPLETED
- Sex
- All
- Target Recruitment
- 120
- Patients undergoing elective coronary artery bypass surgery
- Patients with high anticholinergic burden
- All other procedures except isolated coronary bypass surgery
- Patients with low anticholinergic burden
- Patients whose records cannot be accessed through the data system
Study & Design
- Study Type
- INTERVENTIONAL
- Study Design
- PARALLEL
- Arm && Interventions
Group Intervention Description Remifentanyl, Propofol, Sevoflurane / Desflurane, Propofol reducing anticholinergic burden Preoperative period : There will be no intervention. Intraoperative period : An erector spinae plane block will be applied before anesthesia induction. Drugs with cholinergic burden will not be preferred. Lower anticholinergic drugs will be used. There will be no intervention in the surgical procedure. Postoperative period : Drugs with high cholinergic burden will not be used. Lower anticholinergic drugs will be used. Intraoperative and postoperative periods, instead of drugs with high anticholinergic burden; lower burden drugs will be preferred. High anticholinergic burden drugs: (Fentanyl - Talinat®, Tramadol- Contamal®, Midazolam - Dormicum®, Pancuronium-Mivacron®) Lower burden drugs : (Remifentanyl-Ultiva®, Sevoflurane-Sevoflurane USP® , Desflurane-Suprane®, Propofol-Propofol®, Rocuronium-Esmeron®, Lidocaine-Aritmal®)
- Primary Outcome Measures
Name Time Method Mortality Postoperative 90 days The patient will be visited every day during his/her stay in the hospital, and then the patient will be contacted by phone on the 90th day.Patient information will be checked from the hospital database.
- Secondary Outcome Measures
Name Time Method Effects on postoperative recovery Postoperative 90 days Fraility and the recovery processes of the patients in both preoperative and the postoperative period will be recorded using The Clinical Frailty Scale (which is a nine-point scale based on clinical evaluation of mobility, energy, physical activity, and function.
1-Very Fit 2 -Well 3-Managing Well 4 -Vulnerable 5 -Mildly Frail 6-Moderately Frail 7-Severely Frail 8-Very Severely Frail 9-Terminally IllPostoperative complication Postoperative 90 days It will be monitored whether complications develop and reported if tehy occur, within 90 days.
* Cardiac arrest,
* Cardiac reoperation for bleeding
* Cardiac reoperation other than bleeding
* Deep sternal wound infection
* Stroke (ischemic/hemorrhagic)
* Pneumonia / Pulmonary edema / Pleural effusion
* Infection (urinary infection,wound infection, catheter infection, meningitis, mediastinitis, sepsis)
* Acute renal failure (to be assessed by the KDIGO criteria; increase in sCr ≥0.3 mg/dL (≥26.5 μmol/L) within 48 hours; or increase in sCr ≥1.5 times baseline, which is known or presumed to have occurred within the prior 7 days; or 3 Urine volume \<0.5 mL/kg/h for 6 hours)
The patient will be visited every day during his/her stay in the hospital, and then the patient will be contacted by phone on the 90th day. Patient information will be checked from the hospital database.
Trial Locations
- Locations (1)
Seda Kurtbeyoğlu
🇹🇷Çankaya, Ankara, Turkey