Anesthetics Impact on Brain Blood Flow During Surgery
Trial Summary
Will I have to stop taking my current medications?
The trial information does not specify whether you need to stop taking your current medications. It's best to discuss this with the research staff or your doctor.
What data supports the effectiveness of the drugs Ephedrine and Phenylephrine on brain blood flow during surgery?
Is Ephedra safe for use in humans?
How does this drug affect brain blood flow during surgery?
This treatment is unique because it combines drugs like ephedrine and phenylephrine, which help maintain stable blood flow to the brain during surgery, with anesthetics like propofol and sevoflurane that reduce brain pressure and have anti-nausea effects. The use of light-based neuromonitoring to track brain oxygen levels adds an innovative approach to ensure adequate brain perfusion.211121314
What is the purpose of this trial?
The brain is a highly active organ that requires a large blood flow to function properly. Normally, blood flow is tightly linked to the brain's energy demands. However, during surgery, anesthesia can affect this relationship in different ways. Some types of anesthesia can decrease blood flow to the brain, while others can increase it. Anesthesiologists need to be careful to maintain adequate blood flow to the brain during surgery, especially when blood pressure drops. Drugs may be used to increase blood pressure, but some of these drugs can also affect blood flow to the brain. It is still unclear how to best maintain blood flow to the brain during surgery and how different types of anesthesia and drugs affect this process.The study aims to assess the clinical utility of a new technique that uses light-based neuromonitoring to measure changes in cerebral blood flow and metabolism. The investigators will recruit 80 adult patients undergoing surgery under general anesthesia and randomize them into one of four groups to evaluate the effects of different anesthetic agents and vasopressors on brain hemodynamics and metabolism. The study will include patients over 18 years of age with no history of neurological conditions, substance abuse, or contraindications to cerebral oximetry devices or specific anesthetic agents. The patients will receive standard anesthesia care and be monitored with our light-based neuromonitoring system. This study aims to demonstrate the device's ability to detect changes in cerebral hemodynamic parameters related to anesthesia induction and systemic hypotension. This study will also evaluate the effects of anesthetic maintenance agents and vasopressors on cerebral hemodynamics and neurovascular coupling.
Research Team
Jason Chui, MD
Principal Investigator
Western University
Eligibility Criteria
This trial is for adults over 18 who need general anesthesia for surgery lasting more than an hour. It's not for those with neurological conditions, substance abuse history, skin issues on the forehead, or allergies to certain anesthesia drugs.Inclusion Criteria
Exclusion Criteria
Timeline
Screening
Participants are screened for eligibility to participate in the trial
Anesthesia Induction
Preoperative baseline cerebral hemodynamic and metabolic parameters are measured, followed by anesthesia induction and monitoring of cerebral hemodynamics and metabolism.
Surgery and Treatment
Participants undergo surgery with randomized anesthetic maintenance and vasopressor agents. Continuous monitoring of cerebral blood flow and metabolism using trNIRS/DCS.
Post-Anesthesia Care
Patients are extubated and transferred to the PACU. Neurological outcomes are collected via routine physical exam.
Follow-up
Participants are monitored for safety and effectiveness after treatment.
Treatment Details
Interventions
- Ephedrine
- Light-based neuromonitoring
- Phenylephrine
- Propofol
- Sevoflurane
Ephedrine is already approved in United States, Canada for the following indications:
- Hypotension
- Bronchial asthma
- Narcolepsy
- Myasthenia gravis
- Allergic disorders
- Nasal decongestant
- Asthma
- Bronchitis
Find a Clinic Near You
Who Is Running the Clinical Trial?
Jason Chui
Lead Sponsor