RecruitingNot ApplicableNCT06535230

Anesthesia Induction with the Target-controlled Infusion of Propofol in High-risk Patients

Does Induction of Anesthesia with Target-controlled Propofol Infusion Reduce the Risk of Post-induction Hypotension in High-risk Patients?

Sponsor

Acibadem University

Enrollment

200 participants

Start Date

Aug 30, 2024

Study Type

INTERVENTIONAL

Conditions

Anesthesia Hemodynamic Instability

Summary

The purpose of this study is to compare the risk of hypotension following induction of anesthesia in high-risk patients (American Society of Anesthesiologists risk scores III and IV) using target-controlled infusion (TCI) of propofol versus standard manual induction of anesthesia. Our previously published study compared TCI and manual induction of anesthesia in a general patient population and found that hypotension developed less with TCI induction. This study is a continuation of the other study and will be conducted in high-risk patients.

Eligibility

Min Age: 18 YearsMax Age: 100 Years

Inclusion Criteria3

Patients with the American Society of Anesthesiology physical status 3-4
Underwent major elective surgery
Required intra-arterial blood pressure monitoring before induction.

Exclusion Criteria10

Under 18 years of age
Patients with the American Society of Anesthesiology physical status 1-2
Arrhythmia (atrial fibrillation, frequent premature beat)
Severe valvular heart disease
Morbid obesity
Intubation difficulty
Drug addiction
Treatment with opiates
Pregnancy
Emergency surgery

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Interventions

DRUGManual anesthesia induction

In manual anesthesia induction, anesthetic agents are administered at a fixed dose and rate adjusted according to the patient's weight

DRUGAnesthesia induction with Target controlled infusions (TCI)

Target controlled infusion (TCI) system aims to reach the theoretically targeted blood or brain concentration of anesthetic agents based on the patient's age, weight, and height, with computer-assisted algorithms.

DEVICEHemodynamic monitoring with pressure recording analytical method (PRAM)

The pulse contour device MostCare (Vytech, Vygon, Padova, Italy) provides functional hemodynamic monitoring using the pressure recording analytical method.