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Anesthesia; Reaction | Influence of Anesthesia Technique on Postoperative Evolution After Urogenital Surgical Interventions

Anesthesia; Reaction research study

What is the primary objective of this study?

The study hypothesis is that regional anesthesia offers better outcome for the patients who underwent robot assisted laparoscopic urogenital surgery.

Who is eligible to participate?

Inclusion Criteria: - signed the informed consent without previous renal function alteration respiratory and hemodynamic stability Exclusion Criteria: - refuse to sign the informed consent chronic or and stage renal disease severe systemic diseases

Which medical condition, disease, disorder, syndrome, illness, or injury is researched?

Anesthesia; Reaction

Adverse Effect of Other General Anesthetics

Adverse Anesthesia Outcome

Acute Kidney Injury

Study Interventions

Interventions can include giving participants drugs, medical devices, procedures, vaccines, and other products that are either investigational or already available or noninvasive approaches such as surveys, education, and interviews.

Procedure:epidural catheter insertionA catheter is placed in the epidural space at thoracic level. Analgesia is realised with local anesthetics (Bupivacaine plain 0.125%), administered from the beginning of surgical intervention and 12 hours postoperative on the postoperative care unit and intensive care unit at a rate of 6-8 ml/hour.

Procedure:robot assisted laparoscopic urogenital surgeryThe urogenital laparoscopic surgery is assisted by DaVinci robot. The majority of interventions were prostatectomies.

Study Arms

Research studies and clinical trials typically have two or more research arms. An arm is a group of people who receive the same treatment in the study.

robot general anesthesiaGeneral anesthesia for robot assisted laparoscopic urogenital surgery includes premedication with alprazolam (0.5 mg per os), induction with sufentanil, propofol (1-2 mg/kg), neuromuscular blocking agents (rocuronium 0.5 mg/kg) to facilitate tracheal intubation. Anesthesia is maintained with volatile agents (sevoflurane, desflurane) and reinjection of rocuronium and sufentanil as needed. Robotic assisted laparoscopic interventions are realised with Da Vinci surgical robot, known to assure a minimally invasive approach with good results in urologic surgery. The system consists of an ergonomic surgeon console, a patient cart with four interactive robotic arms, a 3D high resolution visualization interface and specific EndoWrist articulated tools.

robot combined anesthesiaCombined anesthesia is defined as association of epidural analgesia to general anesthesia. Epidural catheter is inserted at low thoracic level in the operation theatre before the induction of anesthesia. Correct position is verified with 15 mg bupivacaine plain 0.5%. Infusion is started after the incision at a rate of 6-8 ml/ hour.Epidural continuous infusion of local anesthetic is maintained 12 hours postoperative in the postoperative anesthesia care unit.

Study Status

Unknown status

Start Date: March 2010

Completed Date: May 2015

Phase: N/A

Type: Interventional

Design:

Primary Outcome: acute kidney injury

Secondary Outcome: postoperative outcome

Study sponsors, principal investigator, and references

Principal Investigator: Daniela Ionescu, MD, Phd

Lead Sponsor: Iuliu Hatieganu University of Medicine and Pharmacy

Collaborator:

More information:https://clinicaltrials.gov/show/NCT01898897

Kurosawa S, Kato M. Anesthetics, immune cells, and immune responses. J Anesth. 2008;22(3):263-77. doi: 10.1007/s00540-008-0626-2. Epub 2008 Aug 7. Review.

Curatolo M. Adding regional analgesia to general anaesthesia: increase of risk or improved outcome? Eur J Anaesthesiol. 2010 Jul;27(7):586-91. doi: 10.1097/EJA.0b013e32833963c8. Review.

Wolf AR. Effects of regional analgesia on stress responses to pediatric surgery. Paediatr Anaesth. 2012 Jan;22(1):19-24. doi: 10.1111/j.1460-9592.2011.03714.x. Epub 2011 Oct 14. Review.

Discuss Alprazolam