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Haemodynamic Effects of Four Sevoflurane Wash-In Strategies After Tracheal Intubation
Sponsor: Ataturk University
Summary
The goal of this clinical trial is to compare how four different ways of starting sevoflurane anaesthesia (the "wash-in" phase) affect the heart and circulation during the first 10 minutes after endotracheal intubation in adults undergoing elective major urological surgery. The main question it aims to answer is whether the wash-in strategy affects cardiac index 10 minutes after intubation. Researchers also compared other haemodynamic variables, the time needed to reach the target anaesthetic concentration (0.8 MAC), sevoflurane consumption, the need for ephedrine to treat low blood pressure, and depth of anaesthesia. After a standard intravenous induction, participants were randomly assigned to one of four sevoflurane wash-in strategies: automated end-tidal-controlled delivery, or manual delivery with 0.5 L/min fresh gas flow and 8% sevoflurane, 1 L/min with 4% sevoflurane, or 2 L/min with 4% sevoflurane. Haemodynamic variables were measured continuously through a radial arterial line using the pressure recording analytical method (PRAM).
Official title: Haemodynamic Effects of Four Sevoflurane Wash-In Strategies After Tracheal Intubation Assessed by the Pressure Recording Analytical Method: A Randomised Controlled Trial
Key Details
Gender
All
Age Range
18 Years - 70 Years
Study Type
INTERVENTIONAL
Enrollment
102
Start Date
2025-01-30
Completion Date
2026-01-30
Last Updated
2026-10-26
Healthy Volunteers
No
Conditions
Interventions
End-tidal-controlled sevoflurane wash-in
After endotracheal intubation, sevoflurane is delivered with the Aisys CS2 workstation in automated end-tidal control mode targeting 0.8 MAC (age-adjusted, workstation-displayed), with a minimum fresh gas flow of 0.5 L/min.
Low-flow high-concentration wash-in (0.5 L/min, 8% sevoflurane)
After endotracheal intubation, sevoflurane wash-in is performed manually with a fresh gas flow of 0.5 L/min and a vaporiser setting of 8% until the workstation-displayed MAC reaches 0.8, after which maintenance is switched to end-tidal control targeting 0.8 MAC (minimum fresh gas flow 0.5 L/min).
Low-flow wash-in (1 L/min, 4% sevoflurane)
After endotracheal intubation, sevoflurane wash-in is performed manually with a fresh gas flow of 1 L/min and a vaporiser setting of 4% until the workstation-displayed MAC reaches 0.8, after which maintenance is switched to end-tidal control targeting 0.8 MAC (minimum fresh gas flow 0.5 L/min).
Moderate-flow wash-in (2 L/min, 4% sevoflurane)
After endotracheal intubation, sevoflurane wash-in is performed manually with a fresh gas flow of 2 L/min and a vaporiser setting of 4% until the workstation-displayed MAC reaches 0.8, after which maintenance is switched to end-tidal control targeting 0.8 MAC (minimum fresh gas flow 0.5 L/min).
Locations (1)
Atatürk University
Erzurum, Turkey (Türkiye)