Comparison Between Target-controlled Infusion of Propofol and Sevoflurane as Maintenance of Anesthesia to Hemodynamic Profile of Renal Transplant Recipient
Condition: Renal Transplant Recipient Patients
Study type: Interventional

Summary: 
      This study aimed to compare the effect of target-controlled infusion of propofol and
      sevoflurane as maintenance of anesthesia to intraoperative hemodynamic profile of renal
      transplant recipient
    

Detailed description: 
      Approval from Ethical Committee of Faculty of Medicine Universitas Indonesia was acquired
      prior conducting the study. Subjects were given informed consent before enrolling the study.
      Subjects were randomized into two groups which are target-controlled infusion (TCI) of
      propofol and sevoflurane. Electrocardiography, pulse oximetry, and non-invasive blood
      pressure were set on subjects in the operating room. Subjects were given intravenous
      ranitidine 50 mg, intravenous ondansetron 4 mg, intravenous methylprednisolone 500 mg,
      intravenous cefoperazone-sulbactam 2 gram, intravenous fentanyl 1 mkg/kg body weight (BW),
      and intravenous midazolam 1,5-2 mg as premedication. Arterial cannula was placed on radial
      artery to monitor arterial pressure. Epidural catheter was set and epidural test dosage was
      administered using epinephrine: lidocaine 2% = 1: 200.000 with 3ml volume. Central venous
      catheter was set using ultrasonography guidance with central venous cannula connected to
      EV1000TM monitor using monitoring kit to obtain hemodynamic profile before induction.
      Bispectral index probe was set on subjects. Induction was done using intravenous fentanyl 3
      mkg/kg BW bolus 30 seconds and intravenous propofol 1-1,5 mg/kg BW bolus 60-90 seconds while
      endotracheal tube intubation was facilitated using intravenous atracurium 0.5 mg/kg BW. After
      subjects were intubated, sevoflurane 1,5-2% was used as maintenance agent for sevoflurane
      group while TCI of propofol was used using Schinder technique effect mode for propofol group.
      The administration of maintenance agent was adjusted by the depth of sedation using
      bispectral index monitor with target of 45-50. After completion of induction, hemodynamic
      profile was recorded once. Intravenous atracuriom 0,2 mg/kg BW was given repeatedly as muscle
      relaxant every 30 minutes after intubation. Fentanyl was given continuously as intraoperative
      analgesic with dosage 2mkg/kgBW/hour. If pulse rate was increased> 20% intraoperatively, an
      additional intravenous fentanyl 1 mkg/kgBW bolus was given. After first incision by operator,
      hemodynamic profile were recorded through screen capture of EV1000TM monitor, data will be
      saved in flash disc and manually on paper. Incision data will be recorded 3 times with 1
      minute interval. Hemodynamic profile at incision is the average of all three recorded times.
      Further data will then be recorded every 15 minutes. After operator has finished preparing
      new kidney field, mannitol will be administered by drip slowly with dosage 0.5-1 gram/kg BW.
      After donor kidney placed on recipient field and renal vein connected, 40 mg intravenous
      furosemide was given. Hemodynamic profile was recorded 1 minute after clamp for renal artery
      has been opened and 15 minutes after. Vasoactive and inotropic drug were titrated if
      necessary to achieve mean arterial pressure before induction.
    

Intervention name(s): Propofol; Sevoflurane
Intervention type(s): Drug; Drug
Intervention description(s): Subjects were given target-controlled infusion of propofol using Schinder technique effect mode with the administration of maintenance agent was adjusted by the depth of sedation using bispectral index monitor with target of 45-50; Subjects were given sevoflurane 1,5-2% as maintenance agent of anesthesia.
Intervention MeSH terms: Propofol; Sevoflurane
Allocation: Randomized
Intervention model: Parallel Assignment
Masking: Quadruple (Participant, Care Provider, Investigator, Outcomes Assessor)
Primary purpose: Supportive Care