Bispectral index guided induction of general anaesthesia in patients scheduled for major abdominal surgery: propofol versus etomidate
| ISRCTN | ISRCTN68690518 |
|---|---|
| DOI | https://doi.org/10.1186/ISRCTN68690518 |
| Protocol serial number | N/A |
| Sponsor | University Medical Centre Maribor (Slovenia) |
| Funder | University Medical Centre Maribor (Slovenia) - Department of Anaesthesiology, Intensive Care Therapy and Pain Management |
- Submission date
- 22/01/2011
- Registration date
- 01/03/2011
- Last edited
- 07/09/2011
- Recruitment status
- No longer recruiting
- Overall study status
- Completed
- Condition category
- Surgery
Prospectively registered
Protocol
Statistical analysis plan
Results
Individual participant data
Record updated in last year
Plain English summary of protocol
Not provided at time of registration
Contact information
Mrs Andreja Möller Petrun
Scientific
Scientific
Ljubljanska ulica 5
Maribor
2000
Slovenia
| andreja@moellerpetrun.net |
Study information
| Primary study design | Interventional |
|---|---|
| Study design | Single-centre double blinded crossover randomised controlled trial |
| Secondary study design | Randomised controlled trial |
| Study type | Participant information sheet |
| Scientific title | Bispectral index guided induction of general anaesthesia in patients scheduled for major abdominal surgery: single-centre double blinded crossover randomised controlled trial of propofol versus etomidate |
| Study acronym | BIS PROPETO |
| Study objectives | We will compare the induction of general anaesthesia with etomidate and propofol both titrated to the same bispectral index value: 1. Can we reach a decrease of the needed dose and an alleviation of the negative haemodynamic effects of the induction agent by titrating it to the needed anaesthesia depth? 2. Which induction agent has more negative haemodynamic effects after intubation in terms of hypotension and bradycardia? 3. Which induction agent is accompanied by more tachycardia and hypertension during laryngoscopy and intubation? 4. Is the time of titration of both induction agents to the appropriate anaesthesia depth comparable? 5. Are the haemodynamic effects of both induction agents comparable? |
| Ethics approval(s) | National Medical Ethics Committee approved on the 28th September 2010 (ref. 117/09/10) |
| Health condition(s) or problem(s) studied | General anaesthesia in major abdominal surgery |
| Intervention | The study will compare the haemodynamic effects of two intravenous induction agents which will be titrated to the appropriate anaesthesia depth monitored with bispectral index monitor. Two groups of patients are scheduled for major abdominal surgery. The only difference between the groups is the random chosen induction agent for general anaesthesia: propofol or etomidate. With a constant rate the induction agent is titrated with a perfusor to a bispectral index of 60, then the infusion is stopped. After 1 minute the patient is intubated and ventilated with a mixture of oxygen and air (40:60) and 1% sevoflurane. Bispectral index, heart rate (HR), oxygen saturation, invasive measured mean arterial pressure (MAP) and cardiac output are measured. The values are written down every minute from 2 minutes before the beginning of the anaesthesia induction until 10 minutes after intubation. A BIS monitor is used to monitor the bispectral index. The haemodynamic parameters are measured with a LiDCOrapid monitor. The time from the beginning of the infusion to the bispectral index 60 and from the beginning of the infusion to the disappearance of the eyelash reflex is also measured. At the end of the follow-up the induction agent is identified and a note of the dose of the induction agent is made. There is a rescue protocol for excessive hypotension (mean arterial pressure [MAP] less than 55 mmHg), hypertension (MAP greater than 100 mmHg), bradycardia (heart rate [HR] less than 40/min), tachycardia (HR greater than 90/min) or arrhythmia. The rescue drugs are: 1. Ephedrine 5 mg, phenylephrine 50 µg or atropine 0.3 mg in case of hypotension or bradycardia 2. Fentanyl 0.01 mg/kg, nitroglycerine 10 - 100 µg/min or esmolol 25 - 200 µg/kg/min in case of hypertension or tachycardia or arrhythmia |
| Intervention type | Drug |
| Phase | Not Applicable |
| Drug / device / biological / vaccine name(s) | Propofol, etomidate |
| Primary outcome measure(s) |
Measured from the start of induction till 10 minutes after intubation: |
| Key secondary outcome measure(s) |
1. Dose of each induction agent |
| Completion date | 01/05/2011 |
Eligibility
| Participant type(s) | Patient |
|---|---|
| Age group | Adult |
| Sex | All |
| Target sample size at registration | 40 |
| Key inclusion criteria | 1. Aged over 40 years, either sex 2. American Society of Anasthesiologists (ASA) grade III 3. Scheduled for major abdominal surgery (large bowel resection, stomach resection, liver resection, Whipple resection) All patients will get an epidural catheter in the lower half of the thoracic spine. |
| Key exclusion criteria | 1. Alcohol-abuse 2. Drug abuse 3. Chronic use of benzodiazepines, opioides or other psychotrophic substances 4. Body mass index greater than 30 5. Anticipated difficult intubation (Mallampati 3 and 4) 6. Kidney disease (serum kreatinin greater than 120 mmol/l) 7. Manifest liver disease 8. Alzheimer disease 9. Epilepsy 10. Left ventricle ejection fraction less than 30% 11. Haemodynamic important heart valve disease 12. Pacemaker |
| Date of first enrolment | 01/11/2010 |
| Date of final enrolment | 01/05/2011 |
Locations
Countries of recruitment
- Slovenia
Study participating centre
Ljubljanska ulica 5
Maribor
2000
Slovenia
2000
Slovenia
Results and Publications
| Individual participant data (IPD) Intention to share | No |
|---|---|
| IPD sharing plan summary | Not provided at time of registration |
| IPD sharing plan |
Study outputs
| Output type | Details | Date created | Date added | Peer reviewed? | Patient-facing? |
|---|---|---|---|---|---|
| Participant information sheet | Participant information sheet | 11/11/2025 | 11/11/2025 | No | Yes |
