Advanced Multimodal Anesthesia Care for Patients Undergoing Oro-maxillofacial Surgery
试验速览
- 阶段
- 不适用
- 状态
- Enrolling By Invitation
- 入组人数
- 80
- 试验地点
- 1
- 主要终点
- permitted hypotension during surgery with adequate depth of anesthesia and cardiac output
研究概览
简要总结
The purpose of this research is to develop from enhanced multimodal anesthesia care to verify and optimize ERAS strategies for orthognathic surgery. If the elements of anesthesia care can be accurately controlled, the harmful pressure factors caused by surgery can be minimized and the patients undergoing facial surgery can be improved.
详细描述
Orthognathic surgery (Orthognathic surgery) is currently one of the most commonly performed surgical items in oral and maxillofacial surgery because it corrects facial deformities, improves teeth chewing and face glowing. In general, the kind of operations are performed under nasotracheal intubating general anesthesia.
Due to the patients were required for motionless, low pressure, controlled ventilation, and adequate analgesia during anesthesia undergoing orthognathic surgery, advanced multimodal anesthesia care developing to the Enhanced Recovery After surgery (ERAS) should be conducted under patient safety. The ERAS concept emphasizes the importance of clinical multidisciplinary teamwork cooperation including of oro-surgeon, anesthesiologist, operating and post-anesthesia care nurses. The core elements of ERAS lies in the management of the entire peri-operative period of anesthesia. In clinical practice, focus on entire anesthesia care during the operation includes of precise anesthesia depth, adequate muscle relaxation, multiple modes of pain controlled and adequate analgesia, stable body temperature maintenance, use of goal-oriented infusion therapy, early extubation, and prevention of postoperative nausea and vomiting.
研究设计
- 研究类型
- Observational
- 观察模型
- Other
- 时间视角
- Prospective
入排标准
- 年龄范围
- 20 Years 至 65 Years（Adult, Older Adult）
- 性别
- All
- 接受健康志愿者
- 否
入选标准
- •America society anesthesiologist classification class I to III patients undergoing oro-maxillo-facial surgery
- •unlimited mouth opening
- •nasotracheal intubation general anesthesia for at least 120 minutes.
- •Exclusion criteria:
- •patients with arthritis with limited mouth opening
- •diabetes with insulin treatment
- •essential hypertension without controlled
- •past history of malignant hyperthermia or personal or family history
- •persistent liver dysfunction
- •chronic renal insufficiency
- •body mass index ≧35 kg/m2.
排除标准
- 未提供
结局指标
主要结局
permitted hypotension during surgery with adequate depth of anesthesia and cardiac output
时间窗: intraoperative 2-6 hours
to decrease intra-operative bleeding as patient undergoing oromaxillofacial surgery, intentional hypotension is allowed. however, adequate depth of anesthesia, proper cardiac output, respiratory parameters, temperatures should be monitored
consumption of inhaled and intravenous anesthetics
时间窗: intraoperative 2-6 hours
to maintain adequate depth of anesthesia during intentional hypotension, consumptions of inhaled and intravenous anesthetics are calculated
次要结局
- time to successfully extubate the nasotracheal tube after anesthesia(from the end of surgery to the post-anesthesia care, assessed up to one hour)
- side effects and adverse events(intraoperative and postoperative stages, assessed up to 48 hours)
- safely discharged from post-anesthesia care unit (postoperative recovery room)(2 hours)