Comparison of Desflurane Anesthesia Versus TIVA-TCI in Patients Undergoing Ophthalmic Ambulatory Surgery
Condition: Ophthalmic; Surgery; Anesthesia
Study type: Interventional

Summary: 
      This is a single-center, randomized, prospective research which aims to investigate the
      advantages and disadvantages between desflurane balanced anesthesia and TIVA-TCI with
      propofol in ophthalmic ambulatory surgery, so that to evaluate a better anesthesia method in
      ophthalmic surgery through a large sample clinical study.
    

Detailed description: 
      Desflurane balanced anesthesia and TIVA-TCI(Total IntraVenous Anesthesia-Target Controlled
      Infusion) are commonly used in ophthalmic ambulatory surgery, however, there is no clear
      evidence to discriminate the advantages and disadvantages between them. This study is
      designed to evaluate a better anesthetic method in ophthalmic surgery through a clinical
      study. This is a single center, randomized, prospective study. 200 patients with American
      Society of Anesthesiologists'(ASA) physical status 1 to 2, aged 18 to 60, scheduled for
      elective strabismus ambulatory and in whom a LMA is indicated for anesthesia are recruited.
      Enrolled patients are randomly assigned into 2 groups: group TIVA (TIVA-TCI with propofol)
      and group Des (Desflurane).In group TIVA, anesthesia is maintained with propofol and
      remifentanil. Propofol is continuously administered via a target-controlled infusion (TCI)
      pump intraoperatively. In group Des, anesthesia is maintained with desflurane.All patients
      received anaesthesia depth monitoring with bispectral index (BIS). The dose of anesthetic is
      adjusted to maintained the BIS value within 40 to 60. At the end of the surgery, inhalant
      anesthetic or infused propofol and remifentanil are discontinued. LMA is removed when patient
      regains consciousness with spontaneous respiration. Patients are then transferred to the post
      anesthetic care unit (PACU) for postoperative follow-up. The primary outcome is awake time,
      the secondary outcomes include discharge time, the stay time in PACU, time of off-bed, Riker
      sedation agitation score (SAS), time of PADSS>9, NRS score when leaving PACU, incidence of
      various complications (postoperative nausea and vomiting (PONV), emergence agitation, etc),
      as well as anesthesia cost. All patients are followed up by calling in one day after the
      surgery.
    

Intervention name(s): desflurane; total intravenous anesthesia; inhalation anesthesia; Propofol; Remifentanil
Intervention type(s): Drug; Procedure; Procedure; Drug; Drug
Intervention description(s): method of anesthesia maintenance with desflurane ranged from 0.5~1.5 MAC during the procedure; method of anesthesia in group TIVA is total intravenous anesthesia(TIVA) during the procedure; method of anesthesia in group DES is inhalation anesthesia with desflurane during the procedure; using propofol as sedative during the procedure of anesthesia and maintaining with propofol Cp 2-4 μg/ml in TCI; using remifentanil as analgesics during the procedure of anesthesia and maintaining with remifentanil 2-4 ng/ml in TCI
Other intervention name(s): Ethane,2--1,1,1,2-tetrafluoro; TIVA; Disoprofol; Remifentanil Hydrochloride for Injection
Intervention MeSH terms: Remifentanil; Anesthetics; Propofol; Desflurane
Allocation: Randomized
Intervention model: Parallel Assignment
Masking: Single (Outcomes Assessor)
Primary purpose: Other
Keywords: Ambulatory surgery; Ophthalmic; Inhalation anesthesia; Desflurane; Total intravenous anesthesia