Inhaled anesthetics versus dexmedetomidine for maintaining general anesthesia
Beyond Inhalational Agents: Dexmedetomidine for Maintenance of General Anesthesia - A Prospective Randomized Clinical Trial
This test compares dexmedetomidine plus remifentanil with desflurane plus remifentanil for adults over 39 having elective endoscopic urologic surgery to see which gives more stable anesthesia and faster recovery.
Quick facts
| Phase | Not applicable |
|---|---|
| Study type | Interventional |
| Enrollment | 150 (estimated) |
| Ages | 39 Years to 99 Years |
| Sex | All |
| Sponsor | Bakirkoy Dr. Sadi Konuk Research and Training Hospital Government |
| Locations | 1 site (Istanbul, Istanbul) |
| Trial ID | NCT07363681 on ClinicalTrials.gov |
What this trial studies
This randomized prospective study enrolled 150 patients aged 39 and older scheduled for elective endoscopic urological procedures at Bakırköy Dr. Sadi Konuk Training and Research Hospital in Istanbul. Patients were randomized to receive either dexmedetomidine with remifentanil or desflurane with remifentanil for maintenance of general anesthesia. Intraoperative monitoring recorded anesthesia depth and hemodynamic parameters continuously, and postoperative outcomes included VAS pain scores, RASS agitation-sedation, and modified Aldrete recovery scores as well as the postoperative ward destination. The protocol aimed to compare intraoperative stability, recovery profiles, and potential environmental advantages of a fully metabolized maintenance agent versus inhaled anesthetics.
Who should consider this trial
Good fit: Ideal candidates are adults aged 39 or older with ASA physical status II–IV who can provide informed consent and are scheduled for elective endoscopic urologic procedures such as URS, TUR-B, PCNL, or TUR-P.
Not a fit: Patients with neuropsychiatric disorders, a history of substance abuse, current psychoactive medication use, those who require conversion to open surgery, younger than 39, or undergoing emergency procedures are unlikely to benefit or be eligible.
Why it matters
Potential benefit: If successful, using dexmedetomidine for maintenance could produce more stable blood pressure and heart rate during surgery, speed recovery in the PACU, and reduce environmentally harmful anesthetic emissions.
How similar studies have performed: Previous studies have shown that adding intraoperative dexmedetomidine to inhaled anesthetics can improve hemodynamic stability and shorten recovery, but replacing inhaled agents entirely with dexmedetomidine for maintenance is less well established.
Eligibility criteria
Show full inclusion / exclusion criteria
Inclusion Criteria * Age ≥ 39 years * Classified as ASA physical status II-IV * Scheduled for elective endoscopic urological surgery (e.g., URS, TUR-B, PCNL, TUR-P) * Scheduled for postoperative follow-up in the Post-Anesthesia Care Unit (PACU) * Ability to provide written informed consent Exclusion Criteria * Requirement for conversion to open surgery during the perioperative period * Patients who decline to participate in the study * Presence of neuropsychiatric disorders (e.g., dementia, Parkinson's disease, epilepsy, or history of head trauma) * History of alcohol or substance abuse * Use of psychoactive medications * Inability to communicate adequately for any reason
Where this trial is running
Istanbul, Istanbul
- Bakirkoy dr. Sadi Konuk — Istanbul, Istanbul, Turkey (Türkiye) (Recruiting)
Study contacts
- Study coordinator: Nalan Saygi̇ Emi̇r
- Email: nasaemir@hotmail.com
- Phone: 00905422363672
How to participate
- Review the eligibility criteria above with your treating physician.
- Visit the official trial page on ClinicalTrials.gov for the most current contact information and recruitment status.
- Contact the listed study coordinator or principal investigator to request pre-screening. Pre-screening is free and never obligates you to enroll.