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The investigators are planning to compare the oxygenation values (Pao2/fio2, lactate etc.) in patients who underwent TCI and inhalation anesthesia in rhinoplasty operation.
Total intravenous anesthesia (TIVA) is a common anesthesia method used today as an alternative to inhalation anesthesia. Loss of consciousness is two important components of general anesthesia, in order to give the patient safe analgesia and not to remember any adverse events related to the operation. While the depth of anesthesia can be controlled by monitoring the minimum alveolar concentration (MAK) in the ventilator devices in the operating room we use modernly, there was no more objective method than measuring the plasma level of drugs in intravenous anesthesia. The schemes created by the anesthetists according to plasma drug levels were used when administering total intravenous anesthesia. Target Controlled Anesthesia (TCI) devices, on the other hand, are pumps that have been used more frequently recently and that can deliver the required blood concentration of a drug in bolus and infusion form according to pharmacokinetics models calculated with personal data. In TCI anesthesia, intravenous infusion of anesthetics provides a more stable drug concentration in the plasma and at the site of action compared to repeated bolus techniques. Thus, it is ensured that the drug remains in the therapeutic range, avoiding the consequences such as over- or under-administration of the drugs. The subject of the study is to determine which of the 2 routinely used methods in rhinoplasty operations affects respiratory functions less.
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| Label | Type | Description | Intervention Names |
|---|---|---|---|
| target controlled infusion (TCI) group | Propofol and remifentanil will be used in TCI anesthesia, and while the patient is under adequate sedation (BIS40-60), muscle relaxation will be provided with 0.6 mg/kg rocurium bromide. While applying TCI anesthesia, the device will use the Minto model for Remifentanil infusion and the Schnider model for Propofol infusion. |
| |
| inhalation anesthesia (IA) groups | During anesthesia induction of patients receiving inhalation anesthesia, 60 mg 2% lidocaine, 2 mg/kg propofol, 0.6 mg/kg rocuronium bromide and 1 mcg/kg fentanyl will be used. Desflurane will be used with a minimum alveolar concentration of 1 and for additional intraoperative sedation. remifentanil will be given between 0.05 and 0.2mcg/kg/min according to the patient's needs. |
| Name | Type | Description | Arm Group Labels | Other Names |
|---|---|---|---|---|
| target controlled infusion (TCI) group | Procedure | Patients in the TCI group will be anesthetized with propofol and remifentanil throughout the operation. Patients included in the inhalation anesthesia group will be anesthetized with desflurane and remifentanil with a bispectral index of 40-60 throughout the operation. |
| Measure | Description | Time Frame |
|---|---|---|
| oxygen concentration change throughout the operation | In both general anesthesia methods, blood gas measurements will be made at certain intervals, and pao2 /fio2 in percent (%) ratio will be recorded. | 6 periods; 0. basal blood gas(preoperation), 5 min after intubation, 2 hours after intubation, 5 minutes before extubation, 8 hours after extubation |
| tissue oxygen use as lactate change throughout the operation | In both general anesthesia methods, blood gas measurements will be made at certain intervals serum lactat values mg/dl ratio will be recorded. | 6 periods; 0. basal blood gas(preoperation), 5 min after intubation, 2 hours after intubation, 5 minutes before extubation, 8hours after extubation |
| airway pressures throughout the operation | Airway pressures in cmH2O will be recorded during both anesthesia methods applied throughout the operation. | during the operation |
| lung compliance throughout the operation | The lung compliance in in ml/cmH2O will be recorded during both anesthesia methods applied throughout the operation. | during the operation |
| Measure | Description | Time Frame |
|---|---|---|
| Nausea | Postoperative nausea, vomiting, recovery time from anesthesia will be recorded. | Postoperative 24 hour |
| vomiting | Postoperative vomiting, recovery time from anesthesia will be recorded. |
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Inclusion Criteria:
Exclusion Criteria:
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Adult patients over the age of 18 who will undergo general anesthesia will be included in the study.
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| Name | Affiliation | Role |
|---|---|---|
| yavuz demiraran | Duzce Univercity Anesthesiogly department | Study Director |
| Facility | Status | City | State | ZIP | Country | Contacts |
|---|---|---|---|---|---|---|
| Gizem Demir Şenoğlu | Düzce | Düzce | Turkey (Türkiye) |
In accordance with the personal data protection law numbered 6698 dated 24.03.2016 in the constitution of the Republic of Turkey, personal information must be stored and protected only by the people conducting the study.
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| ID | Term |
|---|---|
| D014155 | Transcobalamins |
| D044382 | Population Groups |
| D000769 | Anesthesia, Inhalation |
| ID | Term |
|---|---|
| D012712 | Serum Globulins |
| D001798 | Blood Proteins |
| D011506 | Proteins |
| D000602 | Amino Acids, Peptides, and Proteins |
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| Postoperative 24. hour |
| recovery time | Postoperative recovery time from anesthesia will be recorded. | Postoperative 24 hour |
| D002352 |
| Carrier Proteins |
| D005916 | Globulins |
| D003710 | Demography |
| D011154 | Population Characteristics |
| D000768 | Anesthesia, General |
| D000758 | Anesthesia |
| D000760 | Anesthesia and Analgesia |