Desflurane and Sevoflurane in Pediatrics With Elevated Liver Enzymes

Study Overview
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Brief Summary
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It is designed to compare effects of inhaled anaesthetic desflurane and sevoflurane on liver functions in pediatric cancer patients

Detailed Description
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Patients will be randomly allocated into two groups using a sealed envelope technique: desflurane group (Des group, n = 30) and sevoflurane group (sevo group, n = 30). Anesthesia monitoring included electrocardiogram, continuous arterial and pulse oximetry, capnography, urine output, nerve stimulator, and esophageal core temperature. Anesthesia will be induced with Propofol 2 mg/kg ,FentanyL 2 μg/kg and atracurium (0.5 mg/kg) was administered to achieve muscle relaxation before endotracheal intubation. End-tidal desflurane or sevoflurane concentrations during the induction were limited to 2 minimal alveolar concentration (MAC). Concentrations of inhalational anesthetics were measured using an anesthetic gas analyser (Datex-Ohmeda, Helsinki, Finland). For the maintenance of anesthesia, the inspired desflurane or sevoflurane concentration was carefully titrated to maintain the end-tidal concentration of 1 MAC. A constant fresh gas flow of 3 l/min (medical-grade air in oxygen to make inspiratory oxygen fraction 0.5) was used during the maintenance of anesthesia. Ventilation was controlled with a tidal volume of 7-10 ml/kg and ventilatory rate was adjusted to maintain an end tidal carbon dioxide ( CO2 )of 35-40 mmHg. to maintain intraoperative blood pressure (BP) and heart rate (HR) within 20% of preoperative values. additional Atracurium will be administered as appropriate. Nerve stimulator was used to monitor neuromuscular blockade on the right adductor pollicis. Hypotension (a drop in systolic BP to the extent of 30% or more or the systolic BP being less than the preoperative values) was treated with volume replacement and, when necessary, with intravenous ephedrine in incremental doses .Bradycardia (HR < 50 beats per min) was treated with atropine if needed. Aspartate aminotransferase (AST), alanine aminotransferase (ALT), total bilirubin (TB), prothrombin time (PT) expressed in international normalized ratio (INR), albumin, platelet count (PLT), and hemoglobin (Hb) were analysed at preoperative period, immediately after operation, and on the 1st, 2nd, 3rd, 5th and 7th, postoperative days (PODs).

Official Title
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Effects of Desflurane and Sevoflurane Anesthesia on Postoperative Liver Functions in Pediatric Cancer Patients With Elevated Liver Enzymes

Conditions
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Liver Functions Tests

Intervention / Treatment
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* Drug: Desﬂurane
* Drug: Sevoflurane


Participation Criteria
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Eligibility Criteria
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Inclusion Criteria: Age >1 year and < 12 years old. Estimated time of surgeries within 1-3 hours. Elevated liver enzymes less than triple folds. Exclusion Criteria: Patient refusal. Hepatitis positive patients. Raising liver enzymes. Hepatic surgeries.

Ages Eligible for Study
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Minimum Age: 1 Year
Maximum Age: 12 Years

Sexes Eligible for Study
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All

Accepts Healthy Volunteers
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No

Study Plan
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How is the study designed?
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Design Details

Primary Purpose: Treatment
Allocation: Randomized
Intervention Model: Parallel Assignment
Masking: Single


Arms and Interventions

| Participant Group/Arm | Intervention/Treatment |
| --- | --- |
| Active Comparator: desflurane<br>patients to be anesthetized with desflurane | Drug: Desﬂurane<br>* compare effects of inhaled anaesthetic desflurane and sevoflurane on liver functions.<br>* Other names: Suprane;|
| Active Comparator: sevoflurane<br>patients to be anesthetized with sevoflurane | Drug: Sevoflurane<br>* Sevoflurane<br>|

What is the study measuring?
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Primary Outcome Measures

| Outcome Measure | Measure Description | Time Frame |
| --- | --- | --- |
| liver function test | measuring Aspartate aminotransferase (AST) | 6 months | 
| ALT | measuring alanine aminotransferase (ALT) | 6 months | 
| Total bilirubin | measuring total bilirubin (TB) | 6 months | 
| prothrombin time | measuring prothrombin time (PT) expressed in international normalized ratio (INR) | 6 months | 
| Albumin | measuring level of albumin. | 6 months | 

 Terms related to the study
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Keywords Provided by Centre Hospitalier Valida
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Desflurane,Sevoflurane,liver enzymes,cancer