An observational study in Sevoflurane and Desflurane, sponsored by Rajiv Gandhi Cancer Institute & Research Center, India. Completed at 1 site in India. Open to participants aged 20 Years to 65 Years. Per ClinicalTrials.gov, last updated 2024-09-19.
Sponsored by Rajiv Gandhi Cancer Institute & Research Center, India · Observational
This prospective observational study aims to compare sevoflurane and Desflurane consumption in low-flow anaesthesia using the ASA (American Society of Anaesthesiology).
Environmental Sustainability Committee recommendations. The patients aged 20-65 years, ASA I and II undergoing surgery under general anaesthesia were included in the study.
Question: Can we reduce our carbon footprint of desflurane and sevoflurane using low-flow anaesthesia, according to the recommendations of the ASA Environment Sustainability Committee?
PRIMARY To compare the mac hour consumption of sevoflurane and desflurane anaesthetic agents under low flow (one litre/min) conditions To calculate the carbon footprint of sevoflurane and desflurane in the study cases.
SECONDARY To test whether a significant generation of carbon monoxide occurs due to the interaction of sevoflurane/desflurane with soda lime in the closed circuit Groups 1) low-flow sevoflurane (LFS)- 1 L/min gas flow 2) low- flow desflurane (LFD)- 1 L/min gas flow Anaesthesia will be administered according to the recommendations of the ASA Environment Sustainability Committee.
Three strategies to reduce the fresh gas flow and environmental contamination are
OBJECTIVES
PRIMARY To compare the mac hour consumption of sevoflurane and desflurane anaesthetic agents under low flow (one litre/min) conditions To calculate the carbon footprint of sevoflurane and desflurane in the low-flow anaesthesia being used in this study
SECONDARY To test whether a significant generation of carbon monoxide occurs due to the interaction of sevoflurane/desflurane with soda lime in the closed circuit.
Methodology Two groups: 1) low-flow sevoflurane (LFS) 2) low- flow desflurane (LFD) Anaesthesia will be administered according to the recommendations of the ASA Environment Sustainability Committee.
Three strategies to reduce the fresh gas flow and environmental contamination are
Five hundred sixty-four patients aged 20-65 and ASA status I-II scheduled for procedures longer than three hours duration at Rajiv Gandhi Cancer Institute \& Research Center (RGCI\&RC) from 2017-2018 will be included in this study.
Patients having severe cardiac and hepatic problems, renal dysfunction and chronic alcoholism are excluded from the study Computer-generated randomisation will be done to allocate the patients into two equal groups for low-flow sevoflurane and low-flow desflurane anaesthesia.
After the arrival of the patients, aVenous cannula will be inserted; midazolam 0.05 mg. kg-1 will be administered intravenously for anxiolysis. Noninvasive monitors, including electrocardiograms, non-invasive blood pressure monitoring, pulse oximetry, axillary temperature, and bispectral index (BIS), will be applied.
Anaesthesia will be induced with fentanyl (2µg.kg-1 ), propofol (2.5 mg. kg-1 ) and atracurium (0.5mg. kg -1 ) to facilitate endotracheal intubation.
All patients will be mechanically ventilated with a mixture of air-oxygen (50% oxygen + 50% air) in addition to the anaesthetic agent according to the study group using the anaesthesia workstation (Primus®, Dräger, Luebeck, Germany).
The tidal volume will be set at 8mL/kg, and the respiratory frequency will be to maintain an end-tidal CO 2 (Et CO2 ) between 30-35mmHg.
After intubation, anaesthesia will be maintained with the fresh gas flow (FRF) of 4 lit./min and 4% Vol sevoflurane or 6% Vol desflurane in the 50% oxygen/air mixture for 5 minutes.
The fresh gas flow will be decreased to 1 L min-1, and after that, dial concentration will be reduced by 0.5% every 2 minutes to maintain 1 MAC(minimum alveolar concentration).
The dial concentration after that will be adjusted to achieve a value of 1 MAC. An adequate neuromuscular blockade will be achieved by administering atracurium boluses of 0.1mg. kg-1 every 20min.
During skin closure, the anaesthetic will be discontinued, and the patient will receive 100% O 2.
At 25% recovery of the first response to train-of-four stimulation, the neuromuscular blockade will be reversed by neostigmine (4µg.kg-1 ) and atropine (15µg.kg-1 ). ABG( Arterial blood gas) were done baseline and post-procedure.
PARAMETERS TO BE RECORDED:
A. Carbon footprint calculation.
Rajiv Gandhi Cancer Institute & Research Center, India is the lead sponsor of 26 studies on the registry; 3 are open to participants now.
Counted across the registry records on this site, refreshed daily.
564 patients aged 20-65 and ASA status I-II scheduled for procedures longer than three hours duration at RGCI\&RC from 2017-2018 will be included in this study
Go through the criteria one by one — yes, no or not sure — and take the list to your doctor or the study team. Kept in this browser only.
Exclusion Criteria:
Underlined terms in the criteria open these too. Explained by clinicaltrials.gg, not part of the registry record. The study team decides who can take part.
The anaesthetists’ scale of health before surgery: I is healthy, II has a mild illness that is under control, III a severe one, IV a severe illness that is a constant threat to life. V and VI are used for the critically ill and for organ donors.
A reason a treatment, test or procedure should not be given to a particular person, such as an allergy, another illness or a medicine they take.
ASA physical status
The anaesthetists’ scale of health before surgery: I is healthy, II has a mild illness that is under control, III a severe one, IV a severe illness that is a constant threat to life. V and VI are used for the critically ill and for organ donors.
Explained by clinicaltrials.gg, not part of the registry record. The study team decides who can take part.
Contraindication
A reason a treatment, test or procedure should not be given to a particular person, such as an allergy, another illness or a medicine they take.
Explained by clinicaltrials.gg, not part of the registry record. The study team decides who can take part.
Anaesthesia will be administered according to the recommendations of ASA Enviornment Sustainability Committee. Three strategies to reduce the fresh gas flow and enviornmental contamination are 1. Induction: Set the Vaporizer to Deliver a Concentration Greater than Intended 2. Intubation: Turn Off the Fresh Gas Flow, Not the Vaporizer. 3. Maintanance: Minimize Fresh Gas Flow During Maintenance.
Other: Low flow anaesthesia using ASA enviormental sustanibility commitee recomendation
Anaesthesia will be administered according to the recommendations of ASA Enviornment Sustainability Committee. Three strategies to reduce the fresh gas flow and enviornmental contamination are 1. Induction: Set the Vaporizer to Deliver a Concentration Greater than Intended 2. Intubation: Turn Off the Fresh Gas Flow, Not the Vaporizer. 3. Maintanance: Minimize Fresh Gas Flow During Maintenance.
Other: Low flow anaesthesia using ASA enviormental sustanibility commitee recomendation
1. Induction: Set the Vaporizer to Deliver a Concentration Greater than Intended 2. Intubation: Turn Off the Fresh Gas Flow, Not the Vaporizer. 3. Maintanance: Minimize Fresh Gas Flow During Maintenance.
To compare the MAC hour consumption of sevoflurane under low flow conditions. To compare the mac hour consumption of sevoflurane and desflurane anasthetic agents under low flow (one litre/min) conditi
To compare the mac hour consumption of sevoflurane anasthetic agents under low flow (one litre/min) conditions To calculate the carbon foot print of sevoflurane and desflurane in the low flow anaesthesia being used in this study
Time frame: Duration of surgery 4hours,4-6 hours, more than 6hours
To calculate the carbon foot print of sevoflurane and desflurane in low flow anaesthesia
Carbon foot print calculation according to the formula
Time frame: Duration of surgery
To test whether significant generation of carbon monoxide occurs due to interaction of sevoflurane / desflurane with sodalime in the closed circuit.
To test whether significant generation of carbon monoxide occurs due to interaction of sevoflurane / desflurane with sodalime in the closed circuit.
Time frame: end of surgery
Plan to share: No
No publications or documents are linked to this record.
Ran from Feb 2018 to primary completion in Sep 2021, 43 months.
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This study is completed, as verified in Sep 2024. You cannot join it, but the record below documents what was studied.
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Rajiv Gandhi Cancer Institute & Research Center, India