Neurotoxicity of Anesthesia in Middle Aged Patients

Tanta University600 enrolled

Overview

for the last 20 years, the increasing reports from non-human studies have raised suspicion that general anesthetics may cause neurotoxic changes in the developing brain that lead to adverse neurodevelopmental outcomes later in life.there are several case reports of reversible smell and taste dysfunction following exposure to general anesthesia suggesting a possible relationship between anesthetic agents and olfactory dysfunction. this study is to assess the possible neurotoxicity of sevoflurane,isoflurane,and propofol based anesthesia guided by olfactory changes

the primary inhibitory neurotransmitter GABA is found in neuronal synapses involving olfactory bulb. So, the involvement of common GABA pathway implies a possible interaction of general anesthetics with olfactory function. olfactory identification is an associative memory which is found to be facilitated by action of melatonin. involvement of GABA receptor in the transfer of light information from suprachiasmatic nuclei to pineal gland suggests possible interaction of melatonin and anesthetic agents. the aim of the study is to evaluate the possible neurotoxicity of sevoflurane,isoflurane,and propofol based anesthesia guided by olfactory changes

Study Type

OBSERVATIONAL

Enrollment

600

Conditions

Anesthesia; Adverse Effect

Interventions

Anesthesia AgentDRUG

various anesthetic agents used in both general and regional anesthesia

Eligibility

Sex: ALLMin age: 18 YearsMax age: 50 Years

Medical Language ↔ Plain English

Inclusion Criteria: * patients aged 18-50 years * both sex * American society of Anesthesiologists' physical status I and II * elective surgery of duration 90-120 minutes Exclusion Criteria: * patients's refusal * recent airway infection * allergic rhinitis * nasal polyps * history of alcoholism * smoking * pregnancy * menstruating female * mental retardation * psychiatric illness * neurosurgical or oto-rhino-laryngeal surgery * history of olfactory deficits or cognitive impairment * CNS disease e.g. epilepsy * history of first degree relative with alzheimer's disease,dementia, or cognitive dysfunction * those who are unable to answer the tests themselves

Locations (1)

Tanta University, Faculty of Medicine

Tanta, Egypt

Outcomes

Primary Outcomes

olfactory threshold

we will use (10 dilutions) of 4% n-butyl alcohol. The odorant and a blank will be presented to the participant. The test will be progressed from weaker-to-stronger concentrations of odorant. Two bottles will be presented to each participant, an odorant bottle and an identical bottle filled with distilled water. The participant will sniff each one for 9 seconds and then will chose which one smelled stronger. If the participant is incorrect at one concentration, the next higher concentration will be presented. When the correct choice is made, the same concentration of odorant will be presented to the participant until four consecutive correct responses are given.

Time frame: olfactory threshold will be measured at 12 hours preoperative then at 6, 24 and 48 hours postoperative

Secondary Outcomes

olfactory identification

We will use UPSIT test.

Time frame: Smell identification will be measured at 12 hours preoperative then at 6, 24 and 48 hours postoperative

cognitive dysfunction

cognitive dysfunction will be evaluated by mini-mental state examination

Time frame: Cognitive dysfunction will be evaluated at 12 hours preoperative then at 6, 24 and 48 hours postoperative

serum melatonin concentrations

Melatonin levels will be measured in plasma by the enzyme-linked immunosorbent assay (ELISA)

Time frame: serum melatonin will be measured at 12 hours preoperative then at 6, 24 and 48 hours postoperative

Data from ClinicalTrials.gov

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