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This prospective, randomized, single-blinded study is designed to compare the postoperative quality of recovery between propofol based total intravenous anesthesia and desflurane in patients undergoing minimally invasive nephrectomy. We hypothesize that propofol based total intravenous anesthesia can significantly improve the quality of recovery after surgery in patients with minimally invasive nephrectomy.
Adult patients undergoing elective laparoscopic or robotic assisted nephrectomy are randomly allocated to receive propofol based total intravenous anesthesia (n=75) or desflurane (n=75). The quality of recover after surgery using the QoR-15K was assessed by a investigator at postoperative day (POD) 1, 2, and 3. The primary outcome is the QoR-15K at POD 1, 2, and 3 after surgery.
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| Label | Type | Description | Intervention Names |
|---|---|---|---|
| TIVA group | Experimental | Patients receiving total intravenous anesthesia with propofol. |
|
| Desflurane group | Active Comparator | Patients receiving inhalation anesthesia with desflurane. |
|
| Name | Type | Description | Arm Group Labels | Other Names |
|---|---|---|---|---|
| total intravenous anesthesia with propofol | Drug | In the TIVA group, general anesthesia is induced and maintained with a target-controlled infusion of propofol using infusion pump (Orchestra®; Fresenius Vial, Brezins, France). In both groups, remifentanil is continuously infused throughout the surgery for balanced anesthesia, adjusted to maintain arterial pressure. |
| Measure | Description | Time Frame |
|---|---|---|
| quality of recovery | Change in the QoR-15K score from 24 hours to 72 hours postoperatively | at 24 hours, 48 hours, 72 hours postoperatively |
| Measure | Description | Time Frame |
|---|---|---|
| Postoperative pain score | Change in the pain severity measured by the 11-pointed numeric rating scale (0: none/10: worst pain) pain score at resting/movement from 24 hours to 72 hours postoperatively | at 24 hours, 48 hours, 72 hours postoperatively |
| Postoperative nausea and vomiting during the first 24 hours postoperatively |
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Inclusion Criteria:
Exclusion Criteria:
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| Facility | Status | City | State | ZIP | Country | Contacts |
|---|---|---|---|---|---|---|
| Seoul National University Hospital | Seoul | KS013 | South Korea |
| PubMed Identifier | Type | Citation | Retractions |
|---|---|---|---|
| 25500679 | Background | Lee WK, Kim MS, Kang SW, Kim S, Lee JR. Type of anaesthesia and patient quality of recovery: a randomized trial comparing propofol-remifentanil total i.v. anaesthesia with desflurane anaesthesia. Br J Anaesth. 2015 Apr;114(4):663-8. doi: 10.1093/bja/aeu405. Epub 2014 Dec 10. |
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| ID | Term |
|---|---|
| D015742 | Propofol |
| D000769 | Anesthesia, Inhalation |
| D000077335 | Desflurane |
| ID | Term |
|---|---|
| D010636 | Phenols |
| D001555 | Benzene Derivatives |
| D006841 | Hydrocarbons, Aromatic |
| D006844 | Hydrocarbons, Cyclic |
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A prospective randomized single-blinded study
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Patients will receive general anesthesia, therefore they can not know their anesthetic method.
Physicians involved in this study will investigate the outcomes.
|
|
| inhalation anesthesia with desflurane | Drug | In the desflurane group, anesthesia is induced with propofol 1-2 mg/kg and maintained with desflurane (5-7 vol %). In both groups, remifentanil is continuously infused throughout the surgery for balanced anesthesia, adjusted to maintain arterial pressure. |
|
|
Incidence of postoperative nausea and vomiting (%) |
| during the first 24 hours postoperatively |
| Postoperative nausea and vomiting during the 24-48 hours postoperatively | Incidence of postoperative nausea and vomiting (%) | during the 24-48 hours postoperatively |
| Postoperative nausea and vomiting during the 48-72 hours postoperatively | Incidence of postoperative nausea and vomiting (%) | during the 48-72 hours postoperatively |
| Total fentanyl consumption during the first 24 hours postoperatively | Change in the postoperative fentanyl consumption (mcg) via IV patient controlled analgesia from 24 hours to 72 hours postoperatively | during the first 24 hours postoperatively |
| Total fentanyl consumption during the 24-48 hours postoperatively | Change in the postoperative fentanyl consumption (mcg) via IV patient controlled analgesia from 24 hours to 72 hours postoperatively | during the 24-48 hours postoperatively |
| Total fentanyl consumption during the 48-72 hours postoperatively | Change in the postoperative fentanyl consumption (mcg) via IV patient controlled analgesia from 24 hours to 72 hours postoperatively | during the 48-72 hours postoperatively |
| Quality of life at early post-discharge | Change in the Quality of life measured using the EuroQoL 5-dimension 5-level scale (EQ-5D-5L) from baseline to early-postdischarge phase | day before surgery and at 3 weeks after discharge |
| D006838 |
| Hydrocarbons |
| D009930 | Organic Chemicals |
| D000768 | Anesthesia, General |
| D000758 | Anesthesia |
| D000760 | Anesthesia and Analgesia |
| D005019 | Ethyl Ethers |
| D004987 | Ethers |
| D008738 | Methyl Ethers |
| D006845 | Hydrocarbons, Fluorinated |
| D006846 | Hydrocarbons, Halogenated |