Assessing brain blood flow during adult surgery

Cerebral Hemodynamic and Metabolic Responses to Anesthesia and Vasopressors in Adult Surgery: A 2x2 Factorial Design Randomized Controlled Trial With Light-based Neuromonitoring (CHEM-FACT Study)

This study is testing how different anesthesia methods affect blood flow to the brain during surgery to see which ones work best for keeping patients safe.

Quick facts

• Phase: PHASE4
• Study type: Interventional
• Enrollment: 80 (estimated)
• Ages: 19 Years and up
• Sex: All
• Sponsor: London Health Sciences Centre Research Institute OR Lawson Research Institute of St. Joseph's (other)
• Locations: 1 site (London, Ontario)
• Trial ID: NCT05941494 on ClinicalTrials.gov

What this trial studies

This study investigates how different anesthesia techniques and drugs affect cerebral blood flow and metabolism during surgery. It aims to utilize a novel light-based neuromonitoring technique to measure changes in cerebral blood flow in 80 adult patients undergoing general anesthesia for surgeries lasting over one hour. The study will randomize patients to receive various anesthetic agents and vasopressors to determine the best approach for maintaining adequate brain blood flow. Understanding these dynamics could improve patient outcomes during surgical procedures.

Who should consider this trial

Good fit: Ideal candidates are adult patients over 18 years old, classified as ASA I-IV, and scheduled for surgery under general anesthesia lasting longer than one hour.

Not a fit: Patients with neurological conditions, a history of substance abuse, or contraindications to the study's interventions may not benefit from this study.

Why it matters

Potential benefit: If successful, this study could lead to improved methods for maintaining cerebral blood flow during surgery, enhancing patient safety and outcomes.

How similar studies have performed: While the concept of flow-metabolism coupling is well-studied, this specific approach using light-based neuromonitoring during surgery is novel and has not been extensively tested.

Eligibility criteria

Inclusion Criteria:

1. Adult patients over the age of 18 years old.
2. ASA I-IV
3. Undergoing surgery under general anesthesia at London Health Sciences Centre or St. Joseph's Healthcare that is scheduled to last longer than 1 hour.

Exclusion Criteria:

1. Had any neurological conditions such as history of stroke, TIA, neurodegenerative disease, or carotid stenosis
2. Had a history of substance abuse such as heavy cannabis users
3. Have a contraindication of applying the cerebral oximetry device (e.g., skin lesions in the forehead)
4. Have contraindications to receive specific anesthetic agents or vasopressors such as malignant hyperthermia or an allergy.
5. Unable to communicate with the research staff

Where this trial is running

London, Ontario

• London Health Sciences Centre — London, Ontario, Canada (RECRUITING)

Study contacts

• Principal investigator: Jason Chui, MD — Western University
• Study coordinator: Jason Chui, MD

Conditions: Anesthesia, Anesthesia Drugs, Vasopressors, Neuromonitoring