Comparative study of Bispectral Index Guided Vs Standardised Anaesthesia Management on early Post Operative Recovery in elderly patients undergoing prolonged laparoscopic surgeries
试验速览
- 阶段
- 不适用
- 状态
- 尚未招募
- 入组人数
- 72
- 试验地点
- 1
研究概览
简要总结
One of the most crucial, yet modifiable, factors influencing postoperative outcomes is
the depth of anaesthesia. Traditional methods of estimating anaesthetic depth, based
on haemodynamic parameters and clinical signs, may sometimes be inadequate or
misleading in elderly patients due to blunted autonomic responses or age related
altered pharmacodynamics.
The Bispectral Index BIS monitor provides a quantitative, objective, real time
measure of the patient’s level of consciousness and helps titrate adequate depth of
anaesthesia, by analysing the Electroencephalogram EEG. BIS values range from 0
no brain activity to 100 fully awake, with optimal general anaesthesia depth
typically maintained between 40 and 60. Hence BIS monitoring helps avoid both
excessively deep as well as light levels of sedation causing awareness and stress
related complication.
In elderly patients, over sedation is particularly harmful, often leading to delayed
emergence, hypotension, post operative cognitive impairment, in the form ofPost
Operative Delirium, Post Operative Cognitive Dysfunction. Assessing
cognitive impairment through tools like Quality of recovery questionnaire QoR15,
Confusion assessment Method CAM score, Mini mental scale examination MMSE,
provide a better understanding of the post operative recovery profile.
In Prolonged laparoscopic surgeries, the response of the patient during intraoperative
positioning, usage of Carbon dioxide gas, and haemodynamic alterations, could all be
exaggerated when considered for an elderly patient.
Thus, it is crucial to have balanced and optimal anaesthesia management in elderly
patients to avoid complications in post operative care. BIS monitoring addresses these
challenges by helping anaesthesiologists maintain an optimal depth of anaesthesia,
minimising drug overuse while ensuring patient safety.
Hence, a randomised, prospective study is being proposed in MGH, to evaluate the
impact of using BIS monitoring guided anaesthesia in elderly patients undergoing
prolonged laparoscopic surgeries in comparison to empirically guided anaesthesia care
研究设计
- 研究类型
- Interventional
- 分配方式
- Randomized
- 盲法
- Participant and Outcome Assessor Blinded
入排标准
- 年龄范围
- 55.00 Year(s) 至 80.00 Year(s)（—）
- 性别
- All
入选标准
- •Scheduled for elective laparoscopic surgery under general anesthesia ASA physical status I to III Expected anesthesia duration more than 3 hours.
排除标准
- •History of severe psychiatric/neurological illness Drug allergies Drug or alcohol abuse Major organ dysfunction Pre-existing sleep disorders Poor GCS Inability to perform Assessment scores CAM and MMSE Pregnant and lactating female.
研究者
Dr Ananya Chaturvedi
Mahatma Gandhi Medical College And Hospital