End Tidal Carbon Dioxide Concentration and Depth of Anesthesia in Children

Launched by UNIVERSITY OF BRITISH COLUMBIA · Mar 6, 2024

Keywords

ClinConnect Summary

This clinical trial is studying how different levels of carbon dioxide (CO2) during anesthesia affect how sleepy children feel while they are undergoing surgery. Researchers want to find out if adjusting the CO2 levels can help reduce the amount of anesthesia medication children need. This could lead to safer anesthesia with fewer side effects, lower costs, and a smaller environmental impact by using less disposable equipment.

To participate in this trial, children aged 3 to 11 years who are having non-invasive or minimally-stimulating procedures may be eligible. This includes surgeries like dental work or certain types of ear surgery where they will be given anesthesia without making any cuts or causing pain. Participants will receive anesthesia while being closely monitored, and the study will help doctors understand how CO2 levels can improve the anesthesia experience for kids. If you have any questions about eligibility or the study process, feel free to ask the research team!

Gender

ALL

Eligibility criteria

• Inclusion Criteria:
• • Children aged 3 - 11 years undergoing non- or minimally-stimulating elective procedures, defined as anesthesia without skin incision or painful manipulation (e.g., non-invasive imaging, auditory brainstem response testing), middle ear surgery, surgery with effective local or regional anesthesia before surgical incision (e.g dental procedures with local anesthetic infiltration, urology with regional block).
• • American Society of Anesthesiologists (ASA) physical status I and II
• • TIVA technique appropriate throughout induction and maintenance of anesthesia
• • Controlled ventilation via endotracheal tube
• • Anticipated surgical time ≥ 90 minutes: to allow time for anesthetic induction and subsequent testing and washout periods at all three EtCO2 levels.
• Exclusion Criteria:
• • Need for inhalational induction of anesthesia
• • Sedative premedication
• • Use of ketamine intraoperatively
• • Unable to place BIS electrodes due to surgical site or other contraindications (e.g., MRI)
• • Allergy to study drugs (propofol, remifentanil, lidocaine)
• • Depression of conscious level for any reason
• • BMI \<5th or \>95th centile for age
• • History of obstructive or central sleep apnea
• • Known or suspected raised intracranial pressure
• • Recent or historical traumatic brain injury