General Anesthetic Drug Adverse Reaction Clinical Trial
Official title:
The Effect of Desflurane on Myocardial Function in Patients Undergoing Coronary Artery Bypass Grafting
This study is to assess the effect of desflurane on myocardial function in patents who underwent coronary artery bypass grafting.
Desflurane, one of the third-generation inhaled anesthetics, is introduced in clinical
practice in 1990s. Decades of clinical use has provided evidence for desflurane's safe and
efficacious use as a general anesthetic. Compared with other volatile anesthestics, it has
several characteristics: lower blood and lipid solubility, more stable in vitro and the
lowest in vivo metabolism. Its particular low fat solubility properties promote rapid
equilibration and rapid elimination at the end of anesthesia which reduces slow compartment
accumulation and promotes predictable emergence, early extubation, and the ability to
rapidly transfer patients from the operating room to the recovery unit. In addition, several
investigations found that patients with desflurane anesthesia recovered their protective
airway reflexes and awakened to a degree sufficient to minimize the stay in the high
dependency recovery area.
A burgeoning body of investigations has shown that desflurane can directly act on myocardial
and vascular functions. Desflurane has coronary vasodilative effects in in situ canine
hearts which is comparable to sevoflurane does. Although it is controversial regarding to
the effect of desflurane on myocardial excitation-contraction coupling and
electrophysiologic behavior, a elaborated study found desflurane induced a positive
inotropic effect in rat myocardium in vitro compared with isoflurane. A recent study
suggested that desflurane decreased right ventricular contractility much less and maintained
the right over left pressures ratio at more favorable values compared with sevoflurane.
Furthermore, substantial investigations found that clinically relevant concentration
desflurane preconditioning or postconditioning could protect myocardium from
ischemia-reperfusion in mammalian animal models or isolated human cardiac tissues. However,
it is unclear whether desflurane can provide protection for patients with coronary artery
disease. Therefore, this study is designed to investigate the effect of desflurane on
myocardial function in patents who underwent coronary artery bypass grafting.
;
Allocation: Randomized, Endpoint Classification: Safety Study, Intervention Model: Parallel Assignment, Masking: Double Blind (Subject, Investigator), Primary Purpose: Prevention
Status | Clinical Trial | Phase | |
---|---|---|---|
Active, not recruiting |
NCT03210077 -
Romanian Entropy Clinical Study Network
|
||
Completed |
NCT04851574 -
PKPD of Rocuronium and Sugammadex Profile in Pediatric Patients
|
||
Recruiting |
NCT03705728 -
Automated Administration of Intravenous Compared With Inhalatory Anesthesia on the Occurrence of Postoperative Delirium
|
N/A | |
Recruiting |
NCT06180876 -
Effect of Remimazolam on Postoperative Delirium
|
N/A | |
Completed |
NCT05468671 -
Clinical Application Value of Remazolam Combined With Sugammadex Sodium in Anesthesia for Endotracheal Surgery Under Bronchoscopy
|
Phase 4 | |
Recruiting |
NCT06216002 -
Incidence of Residual Neuromuscular Blockade in Fraility in OncoGynae Surgery
|
N/A | |
Recruiting |
NCT05208502 -
Observational of Emergence Time Between Patients Receive General Anesthesia With BIS or Spectrogram EEG Monitor
|
||
Completed |
NCT02617680 -
Factors Affecting the Effective End-tidal Concentration of Desflurane Anaesthesia
|
N/A | |
Recruiting |
NCT05935930 -
Postoperative Effects of Propofol Versus Sevoflurane Anesthesia
|
Phase 4 |