Endoscopic Submucosal DissectionNCT07305857
Comparison of the Effects of Target-Controlled Infusion Method and Manual Propofol Administration on Respiratory Function, Recovery, and Electroencephalogram in Endoscopic Submucosal Dissection Cases
A study of Endoscopic Submucosal Dissection and Target Controlled Infusion of Propofol, run by Marmara University Pendik Training and Research Hospital.
Trial summary
Endoscopic submucosal dissection (ESD) has become widely used as a minimally invasive alternative for the resection of early-stage gastrointestinal neoplasms. Due to the lengthy procedure time and intense pain caused by stretching, cutting, and dissecting the gastric wall during ESD, a deeper level of sedation is… Read more about this study
- Who is it for?
- Ages 18 years and olderHealthy volunteers can take part
- Conditions the study is for
- Endoscopic Submucosal Dissection, Target Controlled Infusion of Propofol, Endoscopy Unit
- Type of treatment
- Injection or infusion, Surgery or procedure
- Could I receive a placebo?
- No, everyone receives an active treatment
- How many people
- 50 participants
- Where
- No sites listed yet
- Study dates
- 1 Jan 2026to 1 Mar 2027
- Phase
- Interventional
- Are there results?
- Not yet: the study is under way
Key requirements
Who can take part, as listed by the sponsor. Only the study team can confirm whether you are eligible, so take this list to your doctor.
- Ages 18 years and older
- All sexes
- Healthy volunteers accepted
- Adult, Older adult
Who may be able to join
- Age: 18-75 years old
- ASA (American Society of Anaesthesiologists) physical status class I-III
- Patients with indications for ESD
- BMI < 35 kg/m²
- Patients who are cooperative and can be monitored
Who cannot join
- Those with cardiac or pulmonary insufficiency,
- Those with neurological diseases,
- Those with severe hepatic or renal dysfunction,
- Those with psychiatric disorders that could affect their level of consciousness,
- Those with allergies or hypersensitivity to propofol, midazolam, and fentanyl, Patients who refuse to participate in the study will not be included in this clinical trial.
Trial locations and contacts
No sites are listed yet. Contact the study team or a site near you to ask about taking part.
About this study
Endoscopic submucosal dissection (ESD) has become widely used as a minimally invasive alternative for the resection of early-stage gastrointestinal neoplasms. Due to the lengthy procedure time and intense pain caused by stretching, cutting, and dissecting the gastric wall during ESD, a deeper level of sedation is recommended compared to traditional endoscopic procedures (1). While ensuring adequate patient immobilisation during ESD, preserving respiratory function and rapid recovery are important clinical goals.
Total intravenous anaesthesia (TIVA) is an alternative method to inhalation anaesthesia, achieved through the combination of agents such as propofol and remifentanil. TIVA applications can be performed using manual or target-controlled infusion (TCI) systems. TCI systems aim to achieve and maintain the targeted plasma or effect site concentration based on pharmacokinetic models. These systems have been shown to provide advantages such as more stable depth of sedation during endoscopy, less haemodynamic fluctuation, and faster recovery (2-4).
Read more
Preserving spontaneous breathing is preferred during ESD procedures, which requires careful monitoring of respiration. The Capnostream® device records four variables (SpO₂, RR, non-invasive EtCO₂, heart rate) every 30 seconds via a nasal cannula and integrates them into a single, dimensionless value called the integrated pulmonary index (IPI). The IPI can range from 1 to 10, with 4 and below requiring intervention and 8 to 10 representing the normal range. Furthermore, the use of the bispectral index (BIS) enables objective monitoring of anaesthesia depth by analysing EEG waves and can increase the safety of the recovery process (5).
This study aims to compare the effects of manual TIVA and TCI applications on recovery time, BIS, and respiratory parameters during ESD procedures in the stomach or colon region performed under sedation in the endoscopy unit. The findings will contribute to the safer and more effective planning of sedation applications.
References;
- Sasaki T, Tanabe S, Azuma M, Sato A, Naruke A, Ishido K, et al. Propofol sedation with bispectral index monitoring is useful for endoscopic submucosal dissection: a randomised prospective phase II clinical trial. Endoscopy. 2012 Jun;44(6):584-9.
- Chang YT, Tsai TC, Hsu H, Chen YM, Chi KP, Peng SY. Sedation for gastrointestinal endoscopy with the application of target-controlled infusion. Turk J Gastroenterol Off J Turk Soc Gastroenterol. 2015 Sep;26(5):417-22.
- Sarraj R, Theiler L, Vakilzadeh N, Krupka N, Wiest R. Propofol sedation in routine endoscopy: A case series comparing target controlled infusion vs manually controlled bolus concept. World J Gastrointest Endosc. 2024 Jan 16;16(1):11-7.
- García Guzzo ME, Fernandez MS, Sanchez Novas D, Salgado SS, Terrasa SA, Domenech G, et al. Deep sedation using propofol target-controlled infusion for gastrointestinal endoscopic procedures: a retrospective cohort study. BMC Anaesthesiol. 10 August 2020;20(1):195.
- Sandler NA, Hodges J, Sabino M. Assessment of recovery in patients undergoing intravenous conscious sedation using bispectral analysis. J Oral Maxillofac Surg Off J Am Assoc Oral Maxillofac Surg. 2001 Jun;59(6):603-11; discussion 611-612.
- Ding Y, White PF. Simplified quality of anaesthesia scoring system. Anaesthesia. 1992 Oct;47(10):906-7.
- Conditions
- Endoscopic Submucosal Dissection, Target Controlled Infusion of Propofol, Endoscopy Unit, Respiratory Complications
- Being tested
- manuel propofol and target controlled infusion propofol
- Keywords
- endoscopic submucosal dissection, target controlled infusion of propofol
What participants receive
What participants receive. In a randomised study each person is assigned to one group by chance.
manuel propofol and target controlled infusion propofolProcedure or surgery
This study aims to compare the effects of manual TIVA and TCI propofol administration on recovery time, BIS, and respiratory parameters during ESD procedures performed in the endoscopy unit under sedation in the stomach or colon region. The findings will contribute to the safer and more effective planning of sedation procedures.
| Study group | Role | What they receive |
|---|---|---|
| manuel TIVA | Experimental | All patients will receive premedication with 0.03-0.05 mg/kg midazolam prior to the procedure. An ECG, SpO2, BIS, non-invasive blood pressure measurement, and Capnostream device nasal cannula will be applied to monitor EtCO2 by collecting exhaled air from the nose via a nasal cannula, and 5 L/min oxygen will be administered. All patients will receive 1-2 mcg/kg fentanyl intravenously.
For patients in the Manual Group, anaesthesia maintenance will be performed with 1% propofol in accordance with routine anaesthesia practice. Bolus doses will be administered as needed during the procedure based on BIS, haemodynamics, and the patient's condition. Receives: Procedure: manuel propofol and target controlled infusion propofol |
| Group TCI | Experimental | All patients will receive premedication with 0.03-0.05 mg/kg midazolam prior to the procedure. An ECG, SpO2, BIS, non-invasive blood pressure measurement, and Capnostream device nasal cannula will be applied to monitor EtCO2 by collecting exhaled air from the nose via a nasal cannula, and 5 L/min oxygen will be administered. All patients will receive 1-2 mcg/kg fentanyl intravenously.
For patients in the TCI group, a 1% propofol solution will be prepared in the perfusor, and the patient's height, weight, age, and gender will be entered into the device. The Schneider model, which calculates the dose based on pharmacokinetic models, will be used with a target plasma concentration of 0.5-3 µg/mL. Doses will be adjusted throughout the procedure based on the patient's BIS, haemodynamics, and condition. Receives: Procedure: manuel propofol and target controlled infusion propofol |
What is being measured
The primary outcome is the main question the study is designed to answer.
integrated pulmonary index value
Integrated pulmonary index values on the capnostream device
Measured: while the procedure continues under anaesthesia
total apneic attack count
Number of apnoeic periods developing as a result of respiratory depression during the procedure
Measured: intraoperative time
Secondary outcomes (3)
total propofol dose (mg)
The amount of propofol used during the case shall be recorded in milligrams.
Measured: end of the case
anaesthesia quality score(0-32)
The anaesthesia quality scoring scale, which assesses respiratory stabilisation and haemodynamic stability, will be used. The score obtained between 0 and 32 will be recorded.
Measured: intraoperative period
post-operative recovery time
The time elapsed from the completion of the procedure until the patient opened their eyes and became cooperative.
Measured: end of the case
Timeline
From the start of the study to its completion; the mark is today. Estimated dates are the sponsor’s plan.
- First posted26 Dec 2025
- Study start1 Jan 2026 (estimated)
- Primary completion1 Jan 2027 (estimated)
- Study completion1 Mar 2027 (estimated)
Resources
- Official record on ClinicalTrials.govThe registry entry this page is built from, with its full change history.
- Other trials for Endoscopic Submucosal DissectionStudies of the same condition, open and under way.
- What the trial phases meanHow a treatment moves from first tests in people to approval.
More details
For doctors and researchers: how the study is designed, who runs it, and its registry IDs.
Study design
- Study type
- Interventional
- Phase
- Phase N/A
- Primary purpose
- Screening
- Allocation
- Randomised
- Intervention model
- Parallel groups
- Masking
- Double blind
- Who is masked
- Participant, Care provider
- Enrolment
- 50 participants (estimated)
Sponsor and investigators
- Lead sponsor
- Marmara University Pendik Training and Research Hospital
- Sponsor type
- University, hospital or other
- Responsible party
- Principal investigator, dilara gocmen, Marmara University Pendik Training and Research Hospital
IDs, dates and publications
- ClinicalTrials.gov ID
- NCT07305857
- Sponsor's protocol ID
- 2025/22/1301
- Status last verified
- Dec 2025
- First submitted
- 12 Dec 2025
- Last updated
- 26 Dec 2025
- Results posted
- No
- Data monitoring committee
- No
- FDA-regulated drug
- No
- FDA-regulated device
- No
- Individual data sharing
- Undecided
Study at a glance
From the registry record, last updated by the sponsor on 26 Dec 2025. Recruitment status is as the sponsor reported it: confirm with the study team.
- Official title
- Comparison of the Effects of Target-Controlled Infusion Method and Manual Propofol Administration on Respiratory Function, Recovery, and Electroencephalogram in Endoscopic Submucosal Dissection Cases
- ClinicalTrials.gov ID
- NCT07305857
- Acronym / sponsor ID
- 2025/22/1301
- Conditions
- Endoscopic Submucosal Dissection, Target Controlled Infusion of Propofol, Endoscopy Unit, Respiratory Complications
- Keywords
- endoscopic submucosal dissection, target controlled infusion of propofol
- Study type
- Interventional
- Recruitment status
- Not yet recruiting
- Enrolment
- 50 participants (estimated)
- Lead sponsor
- Marmara University Pendik Training and Research HospitalUniversity, hospital or other
- Study start
- 1 Jan 2026 (estimated)
- Primary completion
- 1 Jan 2027 (estimated)
- Study completion
- 1 Mar 2027 (estimated)
- First posted
- 26 Dec 2025 (actual)
- Results
- Not posted in the source record
Clinical summary
The research question as the sponsor registered it. This describes what the study plans to test, not what it found.
Endoscopic submucosal dissection (ESD) has become widely used as a minimally invasive alternative for the resection of early-stage gastrointestinal neoplasms. Due to the lengthy procedure time and intense pain caused by stretching, cutting, and dissecting the gastric wall during ESD, a deeper level of sedation is recommended compared to traditional endoscopic procedures (1). While ensuring adequate patient immobilisation during ESD, preserving respiratory function and rapid recovery are important clinical goals.
Total intravenous anaesthesia (TIVA) is an alternative method to inhalation anaesthesia, achieved through the combination of agents such as propofol and remifentanil. TIVA applications can be performed using manual or target-controlled infusion (TCI) systems. TCI systems aim to achieve and maintain the targeted plasma or effect site concentration based on pharmacokinetic models. These systems have been shown to provide advantages such as more stable depth of sedation during endoscopy, less haemodynamic fluctuation, and faster recovery (2-4).
Preserving spontaneous breathing is preferred during ESD procedures, which requires careful monitoring of respiration. The Capnostream® device records four variables (SpO₂, RR, non-invasive EtCO₂, heart rate) every 30 seconds via a nasal cannula and integrates them into a single, dimensionless value called the integrated pulmonary index (IPI). The IPI can range from 1 to 10, with 4 and below requiring intervention and 8 to 10 representing the normal range. Furthermore, the use of the bispectral index (BIS) enables objective monitoring of anaesthesia depth by analysing EEG waves and can increase the safety of the recovery process (5).
This study aims to compare the effects of manual TIVA and TCI applications on recovery time, BIS, and respiratory parameters during ESD procedures in the stomach or colon region performed under sedation in the endoscopy unit. The findings will contribute to the safer and more effective planning of sedation applications.
References;
- Sasaki T, Tanabe S, Azuma M, Sato A, Naruke A, Ishido K, et al. Propofol sedation with bispectral index monitoring is useful for endoscopic submucosal dissection: a randomised prospective phase II clinical trial. Endoscopy. 2012 Jun;44(6):584-9.
- Chang YT, Tsai TC, Hsu H, Chen YM, Chi KP, Peng SY. Sedation for gastrointestinal endoscopy with the application of target-controlled infusion. Turk J Gastroenterol Off J Turk Soc Gastroenterol. 2015 Sep;26(5):417-22.
- Sarraj R, Theiler L, Vakilzadeh N, Krupka N, Wiest R. Propofol sedation in routine endoscopy: A case series comparing target controlled infusion vs manually controlled bolus concept. World J Gastrointest Endosc. 2024 Jan 16;16(1):11-7.
- García Guzzo ME, Fernandez MS, Sanchez Novas D, Salgado SS, Terrasa SA, Domenech G, et al. Deep sedation using propofol target-controlled infusion for gastrointestinal endoscopic procedures: a retrospective cohort study. BMC Anaesthesiol. 10 August 2020;20(1):195.
- Sandler NA, Hodges J, Sabino M. Assessment of recovery in patients undergoing intravenous conscious sedation using bispectral analysis. J Oral Maxillofac Surg Off J Am Assoc Oral Maxillofac Surg. 2001 Jun;59(6):603-11; discussion 611-612.
- Ding Y, White PF. Simplified quality of anaesthesia scoring system. Anaesthesia. 1992 Oct;47(10):906-7.
Study design
- Primary purpose
- Screening
- Allocation
- Randomised
- Intervention model
- Parallel groups
- Masking
- Double blind (participant, care provider)
- Number of arms
- 2
| Arm | Type | Receives |
|---|---|---|
| manuel TIVA | Experimental | Procedure: manuel propofol and target controlled infusion propofolAll patients will receive premedication with 0.03-0.05 mg/kg midazolam prior to the procedure. An ECG, SpO2, BIS, non-invasive blood pressure measurement, and Capnostream device nasal cannula will be applied to monitor EtCO2 by collecting exhaled air from the nose via a nasal cannula, and 5 L/min oxygen will be administered. All patients will receive 1-2 mcg/kg fentanyl intravenously. For patients in the Manual Group, anaesthesia maintenance will be performed with 1% propofol in accordance with routine anaesthesia practice. Bolus doses will be administered as needed during the procedure based on BIS, haemodynamics, and the patient's condition. |
| Group TCI | Experimental | Procedure: manuel propofol and target controlled infusion propofolAll patients will receive premedication with 0.03-0.05 mg/kg midazolam prior to the procedure. An ECG, SpO2, BIS, non-invasive blood pressure measurement, and Capnostream device nasal cannula will be applied to monitor EtCO2 by collecting exhaled air from the nose via a nasal cannula, and 5 L/min oxygen will be administered. All patients will receive 1-2 mcg/kg fentanyl intravenously. For patients in the TCI group, a 1% propofol solution will be prepared in the perfusor, and the patient's height, weight, age, and gender will be entered into the device. The Schneider model, which calculates the dose based on pharmacokinetic models, will be used with a target plasma concentration of 0.5-3 µg/mL. Doses will be adjusted throughout the procedure based on the patient's BIS, haemodynamics, and condition. |
Who may qualify
- Ages
- 18 years and older
- Sex
- All
- Healthy volunteers
- Accepted
- Age groups
- Adult, Older adult
Key inclusion criteria (5 listed)
- Age: 18-75 years old
- ASA (American Society of Anaesthesiologists) physical status class I-III
- Patients with indications for ESD
- BMI < 35 kg/m²
- Patients who are cooperative and can be monitored
Key exclusion criteria (5 listed)
- Those with cardiac or pulmonary insufficiency,
- Those with neurological diseases,
- Those with severe hepatic or renal dysfunction,
- Those with psychiatric disorders that could affect their level of consciousness,
- Those with allergies or hypersensitivity to propofol, midazolam, and fentanyl, Patients who refuse to participate in the study will not be included in this clinical trial.
Eligibility is decided by the study team after screening; this overview does not establish that a patient qualifies. Full inclusion and exclusion criteria.
Interventions
| Intervention | Type | Arms |
|---|---|---|
| manuel propofol and target controlled infusion propofolThis study aims to compare the effects of manual TIVA and TCI propofol administration on recovery time, BIS, and respiratory parameters during ESD procedures performed in the endoscopy unit under sedation in the stomach or colon region. The findings will contribute to the safer and more effective planning of sedation procedures. | Procedure or surgery | Group TCI, manuel TIVA |
Primary outcome
integrated pulmonary index value
Time frame: while the procedure continues under anaesthesia
Integrated pulmonary index values on the capnostream device
total apneic attack count
Time frame: intraoperative time
Number of apnoeic periods developing as a result of respiratory depression during the procedure
3 secondary outcomes
total propofol dose (mg)
Time frame: end of the case
anaesthesia quality score(0-32)
Time frame: intraoperative period
post-operative recovery time
Time frame: end of the case
Results and safety
This study is still under way. Results are not available in the source record yet.
Research links
- Official record on ClinicalTrials.govLast updated by the sponsor 26 Dec 2025.
- Individual participant dataSharing planned: Undecided
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Referral and contact
AzTrials does not enrol participants or take referrals. Contact the study team or a site listed below; they decide who can take part.
Questions about this trial
What is this clinical trial studying?
A study of Endoscopic Submucosal Dissection and Target Controlled Infusion of Propofol, run by Marmara University Pendik Training and Research Hospital.
The full registered description is in the About this study section and the official record.
Who may be eligible to take part?
The sponsor lists 5 inclusion and 5 exclusion criteria. Eligibility is decided by the study team after screening, so read the full criteria and contact a listed site.
Is this clinical trial currently recruiting?
The record says: opening soon, as of the sponsor's last update on 26 Dec 2025. Status can change between updates, so confirm with the study contact before making plans.
What are the possible benefits and risks?
They depend on the study and the treatment, and no study can promise a benefit. The study team explains the known risks during informed consent, before anyone joins; the record itself does not list them.
Are results available for this study?
This study is still under way. Results are not available in the source record yet.
How can a doctor refer a patient or contact the research team?
Contact Dilara Göçmen, Asst Prof (+905413439438, dilaragocmen@yahoo.com), or a site near the patient. AzTrials does not enrol participants or take referrals.
What does the primary outcome measure?
integrated pulmonary index value (time frame: while the procedure continues under anaesthesia). The study lists 2 primary outcomes in all. It is what the study was designed to measure, not a finding.
Where can I read the original study information?
Does a listing mean the treatment is approved or proven to work?
No. A listing means the study is registered. It does not show that the treatment is safe, works, or is approved by a regulator.
How often is this information updated?
AzTrials copies changed records from ClinicalTrials.gov every night and reloads the whole registry every week. The sponsor last updated this record on 26 Dec 2025.