Automated Closed Loop Propofol Anaesthesia Versus Desflurane Inhalation Anaesthesia In Bariatric Surgery
Status:
Completed
Trial end date:
2019-12-02
Target enrollment:
Participant gender:
Summary
Complete recovery from anaesthesia is absolutely desirable in the obese patients to avoid
postoperative airway, oxygen ventilation or sleep apnea related complications. Over the
years, Desflurane has emerged as the anaesthetic agent of choice for maintenance of
anaesthesia in obese patients for its efficient elimination profile and ability to facilitate
early recovery from anaesthesia. Alternatively, Propofol is a commonly used intravenous
anesthetic agent administered as a part of total intravenous anesthesia (TIVA) regimen.
However, it is a lipid soluble drug and there are concerns that it may accumulate in obese
patients due to their increased proportion of body fat Therefore, Propofol TIVA is likely to
result in a prolonged duration of action and consequently, delayed emergence from anaesthesia
and a protracted recovery time. A recent advance in the delivery of Propofol to the patient
is the development of computer-controlled anesthesia delivery systems. These devices deliver
Propofol based on feedback from patient's frontal cortex electrical activity as determined by
monitoring bispectral index (BIS). Evaluation of anesthesia delivery by these systems has
shown that Propofol and maintain depth of anesthesia with far more precision as compared to
manual/simple infusion administration. This, in turn, holds promise that recovery from
Propofol anaesthesia can also be favourable in the obese patients. An indigenously developed
computer-controlled anesthesia delivery sytem is the closed loop anaesthesia delivery system
(CLADS), which has been extensively evaluated in patients belonging to different surgical
settings. The evidence generated with Propofol anaesthesia delivered by CLADS has shown
significant improvement in recovery outcome.The performance of CLADS has not yet been
evaluated in obese surgical patients. We hypothesise that in the obese patients undergoing
bariatric surgery, automated delivery of Propofol using CLADS would allow precision control
of anaesthesia depth, intra-operative haemodynamics, and rapid recovery from anaesthesia. We
plan to conduct a randomised controlled investigation to compare patient recovery profile
following Desflurane anaesthesia versus CLADS empowered Propofol anaesthesia.