Patients Undergoing Robotic Surgery Clinical Trial
Official title:
Evaluation of Quality of Recovery With QoR-15 Score Following Closed-Loop Anaesthesia Delivery System Guided Propofol Versus Desflurane General Anaesthesia in Patients Undergoing Transabdominal Robotic Surgery: A Randomized Controlled Study
Verified date | May 2023 |
Source | Sir Ganga Ram Hospital |
Contact | n/a |
Is FDA regulated | No |
Health authority | |
Study type | Interventional |
Robotic approach to laparoscopic surgery has greatly facilitated undertaking complex surgery inside the abdominal cavity with ease. Robotic surgery is performed under general anaesthesia (GA), which is commonly administered either via the inhalational route or intravenous route. Currently, there is paucity of evidence regarding comprehensive patient outcome following robotic transabdominal surgery. The limited data that is available is restricted to specific outcome parameters such as hemodynamic profile, recovery times, and concomitant effects (post-operative nausea vomiting, pain). QoR (quality of recovery)-15 is a patient self- reported measurement of outcome to assess postoperative QoR. QoR-15 is a15-item questionnaire that assess physical and mental well-being of the patient after anesthesia and surgery. It is the first validated outcome assessment scale that has been evaluated using the Consensus-based Standards for the Selection of health Measurements Instruments (COSMIN) and fulfils the requirements for assessing QoR postoperatively. We plan to conduct this randomized controlled-trial to evaluate postoperative QoR using the QoR-15 questionnaire in patients undergoing robotic abdominal surgery under GA administered by routine techniques, namely, closed-loop anesthesia delivery system (CLADS) controlled total intravenous anesthesia (TIVA) with propofol or inhalation anesthesia with desflurane.
Status | Completed |
Enrollment | 120 |
Est. completion date | May 6, 2023 |
Est. primary completion date | May 6, 2023 |
Accepts healthy volunteers | No |
Gender | All |
Age group | 18 Years to 65 Years |
Eligibility | Inclusion Criteria: - ASA physical status I/II - Undergoing elective robotic surgery of more than 60-minutes duration Exclusion Criteria: - Uncompensated cardiovascular illness (uncontrolled hypertension, atrio-ventricular block, sinus bradycardia, congenital heart disease, reduced left ventricular compliance and diastolic dysfunction) - Pre-existent neurological issues (previous neurosurgical intervention, psychiatric disease, morbid autonomic nervous system: orthostatic hypotension, transient ischemic attacks, history of alcohol/substance abuse, among others) - Hepato-renal insufficiency - Endocrinology problems, e.g. uncontrolled diabetes mellitus, hypothyroidism - Known allergy/hypersensitivity to the study drugs (propofol, desflurane) - Pulmonary dysfunction (chronic restrictive /obstructive lung disease, chronic smokers) - Nutritional ailments: obesity (BMI > 30 kg/m2), malnutrition (severe anaemia [Hb < 8gm%] , hypoalbuminemia [< 3.5gm%], bed-ridden moribund status) |
Country | Name | City | State |
---|---|---|---|
India | Sir Ganga Ram Hospital | New Delhi | Delhi |
Lead Sponsor | Collaborator |
---|---|
Nitin Sethi, DNB |
India,
Type | Measure | Description | Time frame | Safety issue |
---|---|---|---|---|
Primary | Quality-of-recovery | Quality-of-recovery will be assessed using QoR-15 questionnaire | From one day before surgery till postoperative day two | |
Secondary | Anaesthesia depth consistency | Comparison of anaesthesia depth adequacy using Varvel criteria parameters: percentage of the anesthesia time during which the BIS remained +/- 10 of the target BIS (50), median performance error (MDPE), median absolute performance error (MDAPE), and global score | From beginning of anesthesia (0-hours, baseline) till 8 hours intraoperatively | |
Secondary | Changes in intra-operative heart rate (beats per minute) | Comparison of intra-operative heart rate between both the arms will be done | From beginning of anesthesia (0-hours, baseline) till 8 hours intraoperatively | |
Secondary | Change in Intra-operative blood pressure - systolic , diastolic, and mean (mmHg) | Comparison of intra-operative blood pressure- systolic, diastolic, and mean between both the arms will be done | From beginning of anesthesia (0-hours, baseline) till 8 hours intraoperatively | |
Secondary | Early recovery | Time taken by the patient to open his/her eyes after discontinuation of anaesthesia will be noted | From end of anaesthesia till 20-minutes postoperatively | |
Secondary | Early recovery | Time taken for tracheal extubation after discontinuation of anaesthesia will be noted | From end of anaesthesia till 20-minutes postoperatively | |
Secondary | Postoperative Sedation | Will be assessed using Modified Observer's assessment of alertness/sedation scale (OASS). It is a 6 point scale from 0 (fully sedated) to 5 (fully awake) | From end of anaesthesia till 24-hours postoperatively | |
Secondary | Postoperative Nausea and Vomiting | Will be assessed using PONV Scale. It is a 3 point scale from 0 (no nausea & vomiting) to 2 (vomiting present) | From end of anaesthesia till 24-hours postoperatively | |
Secondary | Postoperative Analgeisa | Will be assessed using 10-point numeric rating scale (NRS). It is a 10 point scale from 0 (no pain) to 10 (maximum pain). | From end of anaesthesia till 24-hours postoperatively | |
Secondary | Intra-operative awareness | Will be assessed using modified brice questionnaire. It consists of 5 questions pertaining to assessment of intraoperative awareness. | From the end of anaesthesia till 48-hours postoperatively |