Comparing Sevoflurane With Propofol Sedation in ESRF Patients
Status:
Not yet recruiting
Trial end date:
2022-04-30
Target enrollment:
Participant gender:
Summary
End-stage renal failure (ESRF) cohorts undergo brachiocephalic fistula(BCF) transposition
with supraclavicular block. However, this is inadequate because the incision may extend to
the axillary region which requires intercostobrachial (T2) dermatome blockage. Sedation is
commonly indicated to allay anxiety whilst allowing intraprocedural lignocaine infiltration.
It is challenging to administer safe sedation to ESRF patients due to multiple comorbidities,
polypharmacy, altered pharmacokinetic drug handling. Intraoperative hypotension can be common
and evident from the residual effect of antihypertensive and intravascular hypovolemia from
regular hemodialysis. Midazolam is metabolized to an active metabolite which can accumulate
causes apnea and delayed recovery. TCI propofol needs higher induction doses to achieve
hypnosis causes exaggerated hypotension which may jeopardize organ perfusion. The
investigators are exploring the potential benefit of sevoflurane sedation which are
independent of renal clearance, rapid onset and offset, and ischemic preconditioning property
in ESRF cohorts.