Clinical Research Directory

Comparison of Target-Controlled and Manual Total Intravenous Anesthesia in Supratentorial Surgery

This study aims to investigate the effect of target-controlled infusion using the Eleveld pharmacokinetic model compared with manually controlled total intravenous anesthesia on the incidence of postoperative delirium in patients undergoing supratentorial surgery. Propofol and remifentanil are administered using either target-controlled or manual infusion techniques according to the study protocol. Secondary objectives include comparisons of intraoperative anesthetic consumption, hemodynamic responses, recovery profiles, postoperative pain, and postoperative nausea and vomiting between the two anesthesia strategies. The study seeks to evaluate whether target-controlled infusion provides improved anesthetic management and postoperative outcomes compared with manual total intravenous anesthesia.

Remifentanil Effect on Burst Suppression Ratio

The goal of this clinical trial is to determine whether remifentanil has a facilitating effect on the generation of burst suppression by propofol in adult patients (18-60 years) candidates for elective surgery who require remifentanil and American Society of Anesthesiology (ASA) classification I or II. The main question it aims to answer are: • To determine whether remifentanil has a facilitating effect on the generation of burst suppression by propofol. Participants will undergo general anesthesia with remifentanil and propofol sequentially. After loss of consciousness, remifentanil will be adjusted to a medium or high concentration randomly and it will be determined at what concentration of propofol the burst suppressions are generated. Then, the concentrations of propofol that generate burst suppression associated with either a medium or high concentration of remifentanil will be compared.

Incidence of Slow Delta EEG Frequencies (0.1-1 Hz) Before Burst Suppression

The electroencephalogram (EEG) measures brain waves during general anaesthesia via an electrode placed on the forehead. These brain waves show the different stages of natural sleep as well as the state of the brain when a patient is put under general anaesthesia for an operation. In this research project, the investigators aim to find out if the EEG signal shows slow wave activity (where an EEG wave repeats every 10 to 1 seconds) just before the onset of the burst suppression pattern, where the EEG waveform alternates between very small (suppression) and very large (burst) signals over a period of a few seconds. It is not currently known if and how often this occurs, but if it does, it would be a useful signal to help anaesthetists administer just the right dose of anaesthesia to patients.

The Effects of Anesthesia Depth Monitoring on Postoperative Recovery and Cognitive Functions in the Geriatric Patient Population

This study will be conducted on patients aged 65 and older scheduled for surgery due to lumbar or cervical disc herniation. General anesthesia is routinely used for these types of surgeries in the hospital. In patients receiving general anesthesia, anesthesia depth monitoring is performed. As part of the study, a preoperative anesthesia evaluation will be conducted, which will include age, weight, height, comorbidities, regularly used medications, previous surgical or anesthesia experiences, nutritional habits, mental status, and daily activity levels. On the day of surgery, upon arrival in the operating room, the following will be measured and recorded: * Blood pressure using a non-invasive blood pressure monitor * Heart rate and rhythm via electrocardiogram (ECG) * Blood oxygen level with a pulse oximeter * Anesthesia depth using a forehead-applied sensor All monitoring procedures are non-invasive and painless. Following the placement of these monitoring devices and initial measurements, anesthesia induction and surgery will commence. Throughout surgery, blood pressure, heart rate, and brain activity will be continuously recorded. After the surgical procedure, anesthesia emergence and mental status will be assessed. Preoperative evaluation data and intraoperative recordings will be used solely for research purposes, with patient identity information remaining confidential.