Total Intravenous Versus Inhalational Anesthesia in Patients Undergoing Hip Fracture Surgery

NCT07860996 — Recruiting, 110 participants, Sehit Prof. Dr. Ilhan Varank Sancaktepe Training and Research Hospital

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Effect of Total Intravenous Anesthesia Versus Inhalational Anesthesia on Postoperative Quality of Recovery and Cognitive Outcomes in Patients Undergoing Hip Fracture Surgery

RegistryNCT07860996
StatusRecruiting
Study typeObservational
Enrollment110 (Estimated)
SponsorSehit Prof. Dr. Ilhan Varank Sancaktepe Training and Research Hospital (Other)
ConditionsHip Fracture, Postoperative Recovery
InterventionsPropofol-based Total Intravenous Anesthesia, Sevoflurane-based Inhalational Anesthesia (Other)
Datesstart 2026-09-30, primary completion 2027-03-30 (estimated), completion 2027-03-30 (estimated), first posted 2026-10-06, last updated 2026-10-13
Locations1 site in Turkey (Türkiye)

Related Papers Related Patents Related Grants Related Experts
All trials for Hip Fracture All trials for Postoperative Recovery All trials of Propofol-based Total Intravenous Anesthesia All trials of Sevoflurane-based Inhalational Anesthesia

-Summary

This prospective observational study aims to compare total intravenous anesthesia (TIVA) with sevoflurane-based inhalational anesthesia in patients aged 65 years and older undergoing hip fracture surgery under general anesthesia. The study will evaluate postoperative quality of recovery using the Quality of Recovery-40 (QoR-40) questionnaire and cognitive outcomes, including postoperative delirium and cognitive status. Pain scores, opioid consumption, recovery room stay, postoperative complications, and patient satisfaction will also be recorded. The anesthesia technique will be determined by the attending anesthesiologist as part of routine clinical practice, and the researchers will not interfere with the choice of anesthesia.

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+Detailed description

This is a prospective, single-center observational study involving patients aged 65 years and older who undergo hip fracture surgery under general anesthesia. Patients will be followed according to the anesthesia technique used during routine clinical care: propofol-based total intravenous anesthesia (TIVA) or sevoflurane-based inhalational anesthesia. No intervention or modification of routine anesthesia management will be performed by the investigators.

Demographic characteristics, ASA physical status, comorbidities, preoperative Quality of Recovery-40 (QoR-40) scores, and Mini-Mental State Examination (MMSE) scores will be recorded. Intraoperative data, including anesthesia and surgery duration, hemodynamic parameters, extubation time, and anesthetic and analgesic drug consumption, will also be collected.

On postoperative day 1, QoR-40, numerical rating scale (NRS) pain scores, and postoperative delirium using the 3D-CAM will be assessed. On postoperative day 2, QoR-40 and pain assessments will be repeated, and postoperative opioid consumption, post-anesthesia care unit stay, complications, and patient satisfaction will be recorded. Postoperative questionnaires and cognitive assessments will be performed by an investigator blinded to the anesthesia technique.

+Arms and interventions

ArmTypeInterventionsDescription
TIVAOther: Propofol-based Total Intravenous AnesthesiaPatients undergoing hip fracture surgery under general anesthesia who receive propofol-based total intravenous anesthesia (TIVA) as part of routine clinical care. The anesthesia technique is determined by the attending anesthesiologist, and the investigators do not interfere with treatment selection.
SevofluraneOther: Sevoflurane-based Inhalational AnesthesiaPatients undergoing hip fracture surgery under general anesthesia who receive sevoflurane-based inhalational anesthesia as part of routine clinical care. The anesthesia technique is determined by the attending anesthesiologist, and the investigators do not interfere with treatment selection.
  • Propofol-based Total Intravenous Anesthesia (Other): Propofol-based total intravenous anesthesia administered according to routine clinical practice during hip fracture surgery.
  • Sevoflurane-based Inhalational Anesthesia (Other): Sevoflurane-based inhalational anesthesia administered according to routine clinical practice during hip fracture surgery.

+Outcome measures

Primary outcomes

  • Quality of Recovery-40 (QoR-40) Score on Postoperative Day 1 [Postoperative day 1]: Postoperative quality of recovery will be assessed using the Quality of Recovery-40 (QoR-40) questionnaire. The QoR-40 consists of 40 items evaluating five dimensions of recovery: physical comfort, emotional state, physical independence, psychological support, and pain. Higher total scores indicate better quality of recovery.The total score ranges from 40 to 200, with higher scores indicating better postoperative recovery.

Secondary outcomes

  • Quality of Recovery-40 (QoR-40) Score on Postoperative Day 2 [Postoperative day 2]: Quality of recovery will be reassessed on postoperative day 2 using the Quality of Recovery-40 (QoR-40) questionnaire. The total score ranges from 40 to 200, with higher scores indicating better postoperative recovery.
  • Incidence of Postoperative Delirium [Postoperative day 1]: Postoperative delirium will be assessed using the 3D-CAM assessment.
  • Postoperative Pain Intensity [Postoperative days 1 and 2]: Postoperative pain intensity will be evaluated using the Numerical Rating Scale (NRS).
  • Postoperative Opioid Consumption [Up to postoperative day 2]: Total postoperative opioid consumption will be recorded from routine clinical records.
  • Post-Anesthesia Care Unit Length of Stay [From admission to discharge from the PACU]: Duration of stay in the post-anesthesia care unit (PACU) will be recorded.
  • Incidence of Postoperative Complications [Up to postoperative day 2]: Postoperative complications occurring during the study observation period will be recorded.

+Eligibility

Sex: All, ages: 65 Years to any

Inclusion Criteria:

* Age 65 years or older
* ASA physical status I-III
* Scheduled to undergo elective or emergency hip fracture surgery under general anesthesia
* Provision of informed consent by the patient and/or legal representative

Exclusion Criteria:

* Refusal to participate in the study
* ASA physical status IV-V
* Severe pre-existing neurological or psychiatric disorders, including advanced dementia or severe cognitive impairment preventing communication
* Known hypersensitivity or allergy to propofol or sevoflurane
* History of chronic heavy opioid or sedative substance use
* Inability to communicate in Turkish or to understand and complete the QoR-40 questionnaire

+Locations (1)

FacilityCityCountryStatus
Sancaktepe Sehit Prof. Dr. Ilhan Varank Training and Research HospitalIstanbul, IstanbulTurkey (Türkiye)Recruiting

+Publications

  • Myles PS, Myles DB, Galagher W, Chew C, MacDonald N, Dennis A. Minimal Clinically Important Difference for Three Quality of Recovery Scales. Anesthesiology. 2016 Jul;125(1):39-45. doi: 10.1097/ALN.0000000000001158. PMID 27159009
  • Myles PS, Weitkamp B, Jones K, Melick J, Hensen S. Validity and reliability of a postoperative quality of recovery score: the QoR-40. Br J Anaesth. 2000 Jan;84(1):11-5. doi: 10.1093/oxfordjournals.bja.a013366. PMID 10740540