Anesthesia Techniques, Neuroprotection and Surgical Field in FESS Under Controlled Hypotension

This prospective, randomized controlled trial investigates the effect of four different anesthetic maintenance techniques on surgical field conditions, hemodynamic stability, and neuroprotection during functional endoscopic sinus surgery (FESS) performed under controlled hypotension. Patients are randomly assigned to receive either total intravenous anesthesia with propofol-remifentanil, propofol-remifentanil with adjunct ketamine and magnesium, sevoflurane-remifentanil, or sevoflurane-remifentanil with adjunct ketamine and magnesium. Primary outcomes include serum biomarkers of neuronal injury (S100B and neuron-specific enolase, NSE) measured perioperatively, as well as surgical field visibility and intraoperative bleeding scores. Secondary outcomes include recovery profile and postoperative pain.

NCT Number	NCT07181564
Lead Sponsor	University General Hospital of Patras
Conditions	Magnesium Sulfate, Remifentanil, S 100beta, S100 Beta Protein, Human, Neuron-Specific Enolase, Brain Ischemia, Sevoflurane Anaesthesia, Propofol/Remifentanil +1 more
Enrollment	150 participants
Start Date	2025-09-11
Primary Completion	2026-02-02 (estimated)
Study Completion	2026-03-20 (estimated)
Updated on ClinicalTrials.gov	2025-09-18