Propofol (Astra-Zeneca): Propofol-based total intravenous anesthesia (TIVA) administered via continuous infusion (4-10 mg/kg/h) in combination with remifentanil for maintenance of anesthesia under BIS monitoring during elective lumbar instrumentation surgery.
Sevoflurane: Sevoflurane-based inhalational anesthesia administered at 1-1.3 MAC in combination with remifentanil infusion for maintenance of anesthesia under BIS monitoring during elective lumbar instrumentation surgery.
Study summary
This randomized, single-center, single-masked clinical trial aims to compare the immunomodulatory effects of sevoflurane-based inhalational anesthesia and propofol-based total intravenous anesthesia in obese patients undergoing elective lumbar instrumentation surgery. Seventy patients will be randomized into two groups: a propofol group and a sevoflurane group. Blood samples will be collected preoperatively, at postoperative 6 hours, and at postoperative 24 hours. Pentraxin-3 and serum amyloid A levels will be evaluated as primary inflammatory biomarkers together with IL-6, TNF-α, CRP, glucose, and complete blood count parameters.
Eligibility
Sex
ALL
Min age
18 Years
Max age
65 Years
Healthy volunteers
No
Inclusion Criteria:
* Patients aged between 18 and 65 years
* Patients scheduled for elective lumbar instrumentation surgery
* Body mass index between 30 and 34.9 kg/m²
* Patients who provided written informed consent
Exclusion Criteria:
* Known allergy to inhalational or intravenous anesthetic agents
* Acute or chronic infectious disease
* Autoimmune disease or immunodeficiency
* Surgery within the last 3 months
* Chronic anti-inflammatory or immunomodulatory drug use
* Morbid obesity, defined as BMI \>35 kg/m²
* History of malignancy or active cancer treatment
* Renal failure, defined as GFR \<60 mL/min
* Liver failure, defined as AST or ALT greater than 2 times the upper limit of normal
* Diabetes mellitus, metabolic syndrome, or insulin resistance
* Pregnancy or lactation
* Neurological disease, including epilepsy, multiple sclerosis, or Parkinson's disease
* Alcohol or substance abuse
* Inability to comply with the study protocol or provide informed consent
* Known allergy to study drugs (propofol, sevoflurane, remifentanil)
* Emergency surgery
Primary outcome measure(s)
Change in Pentraxin 3 Level — Baseline, postoperative 6 hours, and postoperative 24 hours Pentraxin 3 level was measured from blood samples to evaluate the immunomodulatory effects of propofol- and sevoflurane-based anesthesia.
Change in Serum Amyloid A Level — Baseline, postoperative 6 hours, and postoperative 24 hours Serum amyloid A level was measured from blood samples to evaluate the inflammatory response after surgery.
This page summarises publicly available registry data for informational purposes — not medical advice. Eligibility is determined by each study team; patients should discuss participation with their clinician.
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