Desflurane and Its Effect on Postoperative Morbidity and Mortality in Patients Undergoing Thoracic Surgery

University of Zurich460 enrolled

Overview

Desflurane and its effect on postoperative morbidity and mortality in patients undergoing thoracic surgery. Halothane, enflurane, isoflurane, sevoflurane, and desflurane are volatile anesthetics, a group of general anesthetics. Because of the hypnotic effects of these agents, attention has mainly focused on the central nervous system. In the last 10 years, however, numerous studies have reported that volatile anesthetic agents interact with membrane structures of the myocardium and thereby attenuate cardiac mechanical dysfunction and limit ultrastructural abnormality on reperfusion after prolonged ischemia in the myocyte. Anesthetic-induced preconditioning has become a main topic in cardiac research worldwide * Trial with medicinal product

Study Type

INTERVENTIONAL

Allocation

RANDOMIZED

Purpose

TREATMENT

Masking

NONE

Enrollment

460

Conditions

Thoracic Surgery

Interventions

Eligibility

Sex: ALLMin age: 18 YearsMax age: 80 Years

Medical Language ↔ Plain English

Inclusion criteria: • Elective thoracic surgery (thoracotomy, thoracoscopy) * Lung resection * One-lung ventilation * Adults (18-80 years of age) * ASA classification I - III * Written consent (signature from patient) Exclusion criteria: * Known hypersensitivity or suspected allergy to propofol, soja or egg proteins * Known hypersensitivity to volatile anesthetics (malignant hyperthermia) * Medication with high dosage of statins * Therapy with cyclosporin * Severe renal impairment (GFR \< 30 ml/min) * Oral steroid treatment at present or stopped less than 3 months before surgery * Inflammatory processes (non-pulmonary or pulmonary): elevated C-reactive protein level (\> 20 mg/l) or leukocytosis (leukocytes \> 10x103/?l) or body temperature \> 37°C) * Pregnancy * Breast feeding * The subject must not be involved in any other clinical trial during the course of this trial, nor within a period of 30 days prior to its beginning or 30 days after its completion

Outcomes

Primary Outcomes

Major complications as defined as ≥ grade IIIa according to classification of surgical complications from Dindo et al. after lung resection with one-lung ventilation during hospitalization

Time frame: postoperative phase until discharge; 6 month after surgery

Secondary Outcomes

Major complications ≥ grade IIIa according to classification of surgical complications from Dindo et al. after dimissio up to 6 months after surgery

Time frame: postoperative phase until discharge, 6 month postoperative

Perioperative inflammatory mediators TNF-α, IL-6, IL-8, sICAM-1, MCP-1, MIP-2 in blood (correlation to complications ≥ grade IIIa according to classification of surgical complications from Dindo et al. during hospitalization)

Time frame: postoperative phase until discharge