Clinical Trial: Sevoflurane and Hyperperfusion Syndrome

Study Status: Not yet recruiting
Recruit Status: Not yet recruiting
Study Type: Interventional

Official Title: Effect of Sevoflurane-induced Postconditioning on the Incidence of Postoperative Cerebral Hyperperfusion Syndrome After Revascularization Surgery in Adult Patients With Moyamoya

Brief Summary: The aim of the present study is to evaluate the effect of sevoflurane postconditioning on the incidence of postoperative hyperperfusion syndrome following revascularization surgery in moyamoya patients.

Detailed Summary: Postoperative hyperperfusion syndrome is a common complication in moyamoya disease patients receiving revascularization surgery. Previously its incidence has been reported to be 17~50%, but little remains regarding frequency of reperfusion injury after revascularization surgery in patients with moyamoya disease. Volatile anesthetics such as sevoflurane has been introduced clinically to reduce reperfusion injury and preconditioning with sevoflurane induced ischemic tolerance like as ischemic preconditioning. However, there was no report on the neuroprotective effect of sevoflurane postconditioning on ischemic/reperfusion injury in human brain. Therefore, We evaluated the neuroprotective effect of sevoflurane postconditioning on the incidence of postoperative hyperperfusion syndrome after revascularization surgery in moyamoya disease patients.
Sponsor: Seoul National University Hospital

Current Primary Outcome: The incidence of postoperative cerebral hyperperfusion syndrome [ Time Frame: postoperative day 15 ]

Cerebral hyperperfusion syndrome was defined if all the following four criteria were met: i) new development of postoperative focal neurological deficits, ii) a delayed neurological deficits which were not shown in the immediate postoperative period; iii) postoperative reversible neurological deficits which were completely resolved within 15 days after operation; iii) neither definite haematomas nor definite acute infarction on a brain CT scan, on diffusion magnetic resonance imaging, or both.


Original Primary Outcome: Same as current

Current Secondary Outcome:

  • The incidence of a new onset postoperative cerebral ischemia [ Time Frame: participants will be followed for the duration of hospital stay, an expected average of 3 weeks. ]
    cerebral ischemia is diagnosed by clinical symptoms and radiologic imaging (CT or MRI).
  • The incidence of a new onset postoperative brain hematoma [ Time Frame: participants will be followed for the duration of hospital stay, an expected average of 3 weeks. ]
    postoperative brain hematoma is diagnosed by clinical symptoms and radiologic imaging (CT or MRI).
  • The incidence of unrecovered neurological deficit [ Time Frame: participants will be followed for the duration of hospital stay, an expected average of 3 weeks. ]
    the incidence of postoperative neurological symptoms which persisted or not fully recovered until the patient's discharge.


Original Secondary Outcome: Same as current

Information By: Seoul National University Hospital

Dates:
Date Received: July 24, 2015
Date Started: August 2015
Date Completion: September 2018
Last Updated: July 26, 2015
Last Verified: July 2015