Co-induction Technique Compared to Standard Inhalational and Intravenous Induction Techniques

Study Overview
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Brief Summary
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Co-induction technique refers to the use of a combination of medications to reach the desired therapeutic target. In the present study, the investigators examined the safety of a novel co-induction approach that relied on a simple timing and dosing alterations to the classical approaches of inhalational sevoflurane and propofol induction. The significance of this study is to find a reliable safe alternative method of induction that can provide optimal parameters,when compared to the classical methods of induction.

Detailed Description
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Co-induction technique refers to the use of a combination of medications to reach the desired therapeutic target. This technique is considered an approach that can be of a great benefit to patients with chronic medical illnesses and those who have moderate to high risk for general anaesthesia. In the present study, the investigators examined the safety of a novel co-induction approach that relied on a simple timing and dosing alterations to the classical approaches of inhalational sevoflurane and propofol induction. The significance of this study is to find a reliable safe alternative method of induction that can provide optimal parameters,when compared to the classical methods of induction. The investigators evaluated the time needed for laryngeal mask airway (LMA) insertion, number of LMA insertion trials, succession of LMA insertion, adverse events related to the airway, respiratory and cardiovascular systems, haemodynamic stability and satisfaction scores of enrolled patients.

Official Title
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A Novel Co-induction Technique Compared to Standard Inhalational and Intravenous Induction Techniques: a Prospective Randomized Control Study

Conditions
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Anesthesia, Anesthesia; Adverse Effect

Intervention / Treatment
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* Drug: Induction using propofol
* Drug: Induction using sevoflurane
* Drug: Induction using propofol and sevoflurane


Participation Criteria
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Eligibility Criteria
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Inclusion Criteria: patients with Age ≥ 65 years. American Society of Anaesthesiologists' (ASA) score II or III. minimally invasive endoscopic urological procedures. Exclusion Criteria: patient refusal. Age < 65 years. family history of malignant hyperthermia. prolonged surgery that needed intubation. body mass index (BMI) > 35 kg/m2.

Ages Eligible for Study
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Minimum Age: 65 Years

Sexes Eligible for Study
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All

Accepts Healthy Volunteers
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Accepts Healthy Volunteers

Study Plan
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How is the study designed?
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Design Details

Primary Purpose: Prevention
Allocation: Randomized
Intervention Model: Parallel Assignment
Masking: None (Open Label)


Arms and Interventions

| Participant Group/Arm | Intervention/Treatment |
| --- | --- |
| Experimental: Group P<br>Patient received a dose of 1.5 mg/kg of Propofol slowly over 2 minutes for induction. | Drug: Induction using propofol<br>* Patients were given 1.5 mcg/Kg of fentanyl intravenously. two minutes after the fentanyl dose, a dose of 1.5 mg/kg of propofol slowly over 2 minutes.<br>|
| Experimental: Group S<br>Patient received 8% sevoflurane through sealed plastic facemask at 8 L/min flow of oxygen. | Drug: Induction using sevoflurane<br>* Patients were given 1.5 mcg/Kg of fentanyl intravenously. two minutes after the fentanyl dose, patient received 8% inhalational sevoflurane through sealed plastic face mask at 8 L/min flow of oxygen.<br>|
| Experimental: Group C<br>Patient received 4% sevoflurane through sealed plastic facemask at 8 L/min flow of oxygen for 2 minutes, followed by a dose of 0.75 mg/kg of propofol given slowly. | Drug: Induction using propofol and sevoflurane<br>* Patients were given 1.5 mcg/Kg of fentanyl intravenously. two minutes after the fentanyl dose, patient received 4% sevoflurane through sealed plastic face mask at 8 L/min flow of oxygen for 2 minutes, followed by a dose of 0.75 mg/kg of propofol given slowly.<br>|

What is the study measuring?
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Primary Outcome Measures

| Outcome Measure | Measure Description | Time Frame |
| --- | --- | --- |
| Intraoperative respiratory adverse events | The investigators recorded the occurrence of transient apnea intraoperatively, in addition to laryngeal spasm, coughing, gagging and increased salivation. The study chart included the documentation these common adverse events, the timing of occurrence, and the intervention required to manage these events. | 8 months | 

Secondary Outcome Measures

| Outcome Measure | Measure Description | Time Frame |
| --- | --- | --- |
| Time for successful laryngeal mask airway insertion | The investigators assessed the time needed for LMA insertion. The timer was started upon giving the fentanyl, recording the time till successful insertion of laryngeal mask airway. | 8 months | 
| Blood pressure stability | The investigators recorded patients' blood pressure readings throughout the induction procedure. | 8 months | 
| Heart rate stability | The investigators recorded patients' heart rate throughout the induction procedure. | 8 months | 
| Changes in oxygen saturation | The investigators recorded patients' oxygen saturation throughout the induction procedure. | 8 months | 

 Terms related to the study
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Keywords Provided by Centre Hospitalier Valida
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General anesthesia, Propofol, Sevoflurane, Co-induction, Laryngeal mask airway