Effect of Thoracic Epidural Analgesia on Intravenous Closed-Loop Anesthesia

Hopital Foch40 enrolled

Overview

The association of general anesthesia and of thoracic epidural anesthesia is used in thoracic surgery with a demonstrated benefit on the risk of postoperative respiratory complications. The objective of the study is to analyze the influence of thoracic epidural administration of chirocaine (5 mg/ml) on the administration of anesthetic agents (propofol and remifentanil), these drugs being administrated using a closed-loop system with the Bispectral Index as the controller. Two groups of patients are compared: * one group will receive general anesthesia and thoracic epidural administration of saline. Chirocaine will be administered before patient's awakening, * one group will receive general anesthesia and thoracic epidural administration of chirocaine (5 mg/ml). In both groups, the closed-loop system ensures that le depth of anesthesia is similar in both groups.

Study Type

INTERVENTIONAL

Allocation

RANDOMIZED

Purpose

TREATMENT

Masking

TRIPLE

Enrollment

Conditions

General Anesthesia

Interventions

Eligibility

Sex: ALLMin age: 18 Years

Medical Language ↔ Plain English

Inclusion Criteria: * patients undergoing a thoracotomy under general anesthesia and epidural anesthesia Exclusion Criteria: * age lower than 18 years, * pregnant woman, * psychotropic treatment, * central neurological disorder or lesion cerebral, * allergy to propofol or to a muscle relaxant, * refusal or contra-indication of epidural anesthesia, * severe emphysema, * coronary disease, * treatment with a beta-blocker or a vasoactive drug.

Outcomes

Primary Outcomes

amount of remifentanil delivered by the closed-loop system

Time frame: end of anesthesia

Secondary Outcomes

amount of propofol delivered by the closed-loop system