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AnesthesiaTSTPNCT07644260

Transition From Sevoflurane to Total Intravenous Anesthesia in Pediatric Patients

An observational study of Anesthesia and Pediatric Anesthesia, run by Hospital de Clinicas José de San Martín at 2 sites in Argentina.

Not yet recruiting

Opening soon. The study is approved but enrolment has not started yet. Sites may already take enquiries.

Sites and contacts
Official record
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Trial summary

his prospective, observational, exploratory, and multicenter study aims to describe the evolution of propofol effect-site concentration administered via target-controlled infusion (TCI) based on the Eleveld model-with adjustments for opioid co-administration-guided by the bispectral index (BIS) during the transition… Read more about this study

Who is it for?
Ages 2 to 12 years
Type of treatment
Injection or infusion
How many people
50 participants
Where
2 sitesArgentina
Study dates
26 May 2026to 28 Mar 2027
How long will I take part?
1 Day
Phase
Observational
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 2 to 12 years
  • All sexes
  • No healthy volunteers
  • Child

Study population: Pediatric patients aged 2 to 12 years scheduled for elective low- or intermediate-risk surgery at Hospital de Clínicas José de San Martín and Hospital General de Niños Pedro de Elizalde, Buenos Aires, Argentina. Recruitment will aim for balanced representation across three age strata (2 to <4 years, 4 to <8 years, and 8 to 12 years), although age stratification is not an inclusion criterion. Patients will be enrolled by consecutive non-probability sampling over an estimated 4-month period, with a target sample size of 50 participants.

Who may be able to join

  • Age 2 to 12 years
  • Scheduled for elective low- or intermediate-risk surgery according to the National Institute for Health and Care Excellence (NICE) surgical risk stratification (e.g., tonsillectomy, adenoidectomy, postioplasty, orchidectomy, orchidopexy, inguinal herniorrhaphy)
  • American Society of Anesthesiologists (ASA) Physical Status Classification I or II

Who cannot join

  • Refusal of parents/legal guardians to sign informed consent, or refusal of the child to provide assent when applicable
  • Cardiovascular or neurological disease that may interfere with anesthesia or with the pharmacokinetic model
  • History of allergy or adverse reaction to inhalational or intravenous anesthetic agents used in the protocol
  • Airway malformations or conditions that complicate standard intubation or airway management
  • Psychological or neurological conditions requiring sedative or hypnotic premedication prior to the anesthetic procedure
  • Treatment with drugs that may alter the pharmacokinetics or pharmacodynamics of the anesthetic agents
  • Difficult peripheral venous access

Trial locations and contacts

2 sites in 1 country. Contact the study team or a site near you to ask about taking part.

Stella Verlangieri, MD contact

541144905757

sverlangieri@gmail.com

Argentina2 sites
  • Hospital General de Niños Pedro de Elizalde

    C.a.b.a., C.a.b.a., 1270

    Gonzalo Alberto Tejeda, MD, +54 9 2314 47-3867, gonzalotejedamed@gmail.com

    Nicolas Alejandro Rzza, MD, +54 9 11 6010-7126, nicolas.alejandro.rizza@gmail.com

  • Hospital de Clinicas Jose de San Martin

    C.a.b.a., C.a.b.a., 1881

    Manuel Cuevas, MD, 02494675554, manuel.cuevas@anestesiologo.org

    Stella Verlangieri, MD, 54 9 11 4490-5757, sverlangieri@gmail.com

Other trials in Argentina

About this study

Official title: Observational Analysis of the Transition From Inhalational Anesthesia to Total Intravenous Anesthesia Guided by Bispectral Index and the Eleveld Model in Pediatric Patients

his prospective, observational, exploratory, and multicenter study aims to describe the evolution of propofol effect-site concentration administered via target-controlled infusion (TCI) based on the Eleveld model-with adjustments for opioid co-administration-guided by the bispectral index (BIS) during the transition from inhalational anesthesia with sevoflurane to total intravenous anesthesia (TIVA) in pediatric patients.The study population will include 50 pediatric patients, aged 2 to 12 years, scheduled for elective low- or medium-complexity surgeries. Induction will be performed with sevoflurane, followed by intravenous access placement and transition to TIVA using propofol and remifentanil via TCI. As part of the neuromonitoring, the bispectral index, spectral edge frequency (SEF), and median frequency (MF) will be recorded. Additionally, hemodynamic parameters will be recorded on a minute-by-minute basis.The primary objective is to describe BIS-guided adjustments of propofol during the anesthetic transition. Secondary objectives include describing interindividual variability in propofol titration, time to reach a BIS of 40-60, burst suppression patterns, SEF, MF, drug consumption, hemodynamic stability, and clinical adverse events. Statistical analysis will be primarily descriptive, examining correlations between BIS, propofol, and the minimum alveolar concentration (MAC) of sevoflurane.

Keywords
Total Intravenous Anesthesia, TIVA, Bispectral Index, BIS, Propofol, Sevoflurane, Eleveld, Target-Controlled Infusion, TCI, Pediatric Anesthesia, Anesthesia Transition

What participants receive

What participants receive. In a randomised study each person is assigned to one group by chance.

Study groups in NCT07644260
Study groupRoleWhat they receive
Pediatric patients undergoing sevoflurane to TIVA transitionPediatric patients aged 2-12 years scheduled for elective low or intermediate risk surgery, undergoing standard sevoflurane mask induction followed by transition to total intravenous anesthesia with propofol via target-controlled infusion (Eleveld model) and remifentanil, guided by Bispectral Index monitoring.

What is being measured

The primary outcome is the main question the study is designed to answer.

  1. Temporal evolution of propofol effect-site concentration under Eleveld-model TCI during anesthetic transition

    Pattern of propofol effect-site concentration (Ce) adjustments (mcg/mL) over time during the transition from sevoflurane inhalation anesthesia to TIVA. Propofol is administered via target-controlled infusion using the Eleveld pharmacokinetic-pharmacodynamic model with adjustment for opioid co-administration. Ce values are titrated under BIS-guided monitoring to maintain BIS between 40 and 60, as a function of decreasing sevoflurane minimum alveolar concentration.

    Measured: From start of propofol infusion (T0, when sevoflurane MAC = 1.0 for age), until sevoflurane MAC = 0, or a maximum of 15 minutes, whichever occurs first.

Secondary outcomes (6)
  1. Interindividual variability in propofol titration

    Distribution of propofol effect-site concentration values required to maintain target BIS, expressed as mean, SD, median, and IQR across patients.

    Measured: Throughout the transition period (up to 15 minutes from start of propofol infusion)

  2. Time to reach target BIS range (40-60)

    Time elapsed from start of propofol infusion until BIS first reaches 40-60 (minutes).

    Measured: Up to 15 minutes from start of propofol infusion.

  3. Time outside target BIS range

    Cumulative time with BIS <40 and BIS >60 during transition (minutes).

    Measured: Up to 15 minutes from start of propofol infusion

  4. Duration of cortical suppression episodes

    Total time with EEG suppression detected by BIS monitor (minutes).

    Measured: Up to 15 minutes from start of propofol infusion

  5. Spectral edge frequency (SEF) and median frequency (MF) over time

    Time course of SEF and MF (Hz) recorded minute by minute from processed EEG.

    Measured: Up to 15 minutes from start of propofol infusion

  6. Incidence of intraoperative hemodynamic adverse events

    Frequency of hypotension (≥20% drop in MAP from baseline), hypertension (≥20% rise in MAP from baseline), bradycardia (HR below age-adjusted normal range), and tachycardia (HR above age-adjusted normal range).

    Measured: Up to 15 minutes from start of propofol infusion

Timeline

From the start of the study to its completion; the mark is today. Estimated dates are the sponsor’s plan.

  1. First posted12 Jun 2026
  2. Study start26 May 2026 (estimated)
  3. Primary completion31 Oct 2026 (estimated)
  4. Study completion28 Mar 2027 (estimated)

Resources

More details

For doctors and researchers: how the study is designed, who runs it, and its registry IDs.

Study design
Study type
Observational
Observational model
Cohort
Time perspective
Prospective
Enrolment
50 participants (estimated)
Target duration
1 Day
IDs, dates and publications
ClinicalTrials.gov ID
NCT07644260
Sponsor's protocol ID
PED-TIVA-TRANS
Other IDs
TSTP01
Acronym
TSTP
Status last verified
Jun 2026
First submitted
6 May 2026
Last updated
12 Jun 2026
Results posted
No
Data monitoring committee
No
FDA-regulated drug
No
FDA-regulated device
No
Individual data sharing
Undecided: A formal individual participant data (IPD) sharing plan has not yet been established. The current informed consent and assent forms approved by the Ethics Committees do not specifically authorize sharing of individual-level data with third parties; only aggregated, anonymized results are planned for dissemination through scientific publications and conference presentations. A decision regarding IPD sharing may be reconsidered after study completion, subject to ethics committee approval, additional consent provisions if required, and a formal data sharing agreement.

Publications

  • Eleveld DJ, Proost JH, Vereecke H, Absalom AR, Olofsen E, Vuyk J, Struys MMRF. An Allometric Model of Remifentanil Pharmacokinetics and Pharmacodynamics. Anesthesiology. 2017 Jun;126(6):1005-1018. doi: 10.1097/ALN.0000000000001634.

    PubMed 28509794
  • Degoute CS, Macabeo C, Dubreuil C, Duclaux R, Banssillon V. EEG bispectral index and hypnotic component of anaesthesia induced by sevoflurane: comparison between children and adults. Br J Anaesth. 2001 Feb;86(2):209-12. doi: 10.1093/bja/86.2.209.

    PubMed 11573661
  • Kreuer S, Wilhelm W. The Narcotrend monitor. Best Pract Res Clin Anaesthesiol. 2006 Mar;20(1):111-9. doi: 10.1016/j.bpa.2005.08.010.

    PubMed 16634418
  • McFarlan CS, Anderson BJ, Short TG. The use of propofol infusions in paediatric anaesthesia: a practical guide. Paediatr Anaesth. 1999;9(3):209-16.

    PubMed 10320599
  • Dennhardt N, Boethig D, Beck C, Heiderich S, Boehne M, Leffler A, Schultz B, Sumpelmann R. Optimization of initial propofol bolus dose for EEG Narcotrend Index-guided transition from sevoflurane induction to intravenous anesthesia in children. Paediatr Anaesth. 2017 Apr;27(4):425-432. doi: 10.1111/pan.13118. Epub 2017 Feb 18.

    PubMed 28213945
  • Nimmo AF, Absalom AR, Bagshaw O, Biswas A, Cook TM, Costello A, Grimes S, Mulvey D, Shinde S, Whitehouse T, Wiles MD. Guidelines for the safe practice of total intravenous anaesthesia (TIVA): Joint Guidelines from the Association of Anaesthetists and the Society for Intravenous Anaesthesia. Anaesthesia. 2019 Feb;74(2):211-224. doi: 10.1111/anae.14428. Epub 2018 Oct 31.

    PubMed 30378102
  • Davidson AJ, Sale SM, Wong C, McKeever S, Sheppard S, Chan Z, Williams C. The electroencephalograph during anesthesia and emergence in infants and children. Paediatr Anaesth. 2008 Jan;18(1):60-70. doi: 10.1111/j.1460-9592.2007.02359.x.

    PubMed 18095968
  • Lee JM, Akeju O, Terzakis K, Pavone KJ, Deng H, Houle TT, Firth PG, Shank ES, Brown EN, Purdon PL. A Prospective Study of Age-dependent Changes in Propofol-induced Electroencephalogram Oscillations in Children. Anesthesiology. 2017 Aug;127(2):293-306. doi: 10.1097/ALN.0000000000001717.

    PubMed 28657957
  • Purdon PL, Sampson A, Pavone KJ, Brown EN. Clinical Electroencephalography for Anesthesiologists: Part I: Background and Basic Signatures. Anesthesiology. 2015 Oct;123(4):937-60. doi: 10.1097/ALN.0000000000000841.

    PubMed 26275092
  • Vellinga R, Hannivoort LN, Introna M, Touw DJ, Absalom AR, Eleveld DJ, Struys MMRF. Prospective clinical validation of the Eleveld propofol pharmacokinetic-pharmacodynamic model in general anaesthesia. Br J Anaesth. 2021 Feb;126(2):386-394. doi: 10.1016/j.bja.2020.10.027. Epub 2020 Dec 13.

    PubMed 33317804
  • Eleveld DJ, Colin P, Absalom AR, Struys MMRF. Pharmacokinetic-pharmacodynamic model for propofol for broad application in anaesthesia and sedation. Br J Anaesth. 2018 May;120(5):942-959. doi: 10.1016/j.bja.2018.01.018. Epub 2018 Mar 12.

    PubMed 29661412

Questions about this trial

What is this clinical trial studying?

An observational study of Anesthesia and Pediatric Anesthesia, run by Hospital de Clinicas José de San Martín at 2 sites in Argentina.

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 3 inclusion and 7 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 12 Jun 2026. Status can change between updates, so confirm with the study contact before making plans.

Where is the study taking place?

The record lists 2 sites in Argentina. Whether a site is taking part right now should be confirmed with that site. See every site.

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 Manuel Cuevas, MD (542494675554, manuel.cuevas@anestesiologo.org), or a site near the patient. AzTrials does not enrol participants or take referrals.

What does the primary outcome measure?

Temporal evolution of propofol effect-site concentration under Eleveld-model TCI during anesthetic transition (time frame: From start of propofol infusion (T0, when sevoflurane MAC = 1.0 for age), until sevoflurane MAC = 0, or a maximum of 15 minutes, whichever occurs first.). It is what the study was designed to measure, not a finding.

Where can I read the original study information?

On the ClinicalTrials.gov record for NCT07644260, which also lists 11 linked publications.

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 12 Jun 2026.

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