Controlled Hypotension for Nasal SurgeriesNCT07832305
Effects of Different MAP Targets on Ocular Perfusion and Optic Nerve Microvasculature During Rhinoplasty
A study testing Lower MAP Target Strategy (50-60 mmHg) and Higher MAP Target Strategy (60-70 mmHg) in people with Controlled Hypotension for Nasal Surgeries, run by Hitit University at 1 site in Turkey (Türkiye).
Trial summary
This randomized controlled trial aims to evaluate the effects of two different mean arterial pressure (MAP) targets during controlled hypotension on ocular perfusion and optic nerve head microvasculature in patients undergoing elective rhinoplasty or septorhinoplasty. Read more about this study
- Who is it for?
- Ages 18 years and older
- Conditions the study is for
- Controlled Hypotension for Nasal Surgeries
- What is being tested?
- Lower MAP Target Strategy (50-60 mmHg) and Higher MAP Target Strategy (60-70 mmHg)
- Could I receive a placebo?
- No, everyone receives an active treatment
- How many people
- 60 participants
- Where
- 1 siteTurkey (Türkiye)
- Study dates
- 20 Sep 2026to 15 Dec 2026
- 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
- No healthy volunteers
- Adult, Older adult
Who may be able to join
- Age 18-50 years
- Scheduled for elective rhinoplasty or septorhinoplasty
- American Society of Anesthesiologists (ASA) physical status I-II
- Willing and able to provide written informed consent
Who cannot join
- History of glaucoma, retinal disease, optic neuropathy, or other significant ophthalmologic disease
- Previous ocular surgery
- High myopia
- Uncontrolled hypertension, diabetes mellitus, or other serious systemic disease
- ASA physical status III or higher
- Development of severe intraoperative hemodynamic instability
Show all 10Show fewer
- Massive intraoperative bleeding
- Inadequate OCTA image quality for analysis
- Pregnancy
- Refusal to participate or withdrawal of consent
Trial locations and contacts
1 site in 1 country. Contact the study team or a site near you to ask about taking part.
Turkey (Türkiye)1 site, 1 recruiting
- Recruiting
Hitit university
Çorum
Ozgur Yagan, Professor, +90 364 222 11 00, tipfak@hitit.edu.tr
About this study
Official title: Effects of Different Mean Arterial Pressure Targets on Ocular Perfusion and OCTA-Derived Optic Nerve Head Microvasculature During Controlled Hypotension in Rhinoplasty: A Prospective Randomized Controlled Trial
This randomized controlled trial aims to evaluate the effects of two different mean arterial pressure (MAP) targets during controlled hypotension on ocular perfusion and optic nerve head microvasculature in patients undergoing elective rhinoplasty or septorhinoplasty.
A total of 60 patients will be randomized in a 1:1 ratio to a target MAP of either 50-60 mmHg or 60-70 mmHg during general anesthesia. Intraocular pressure (IOP) will be measured at predefined perioperative time points, and estimated ocular perfusion pressure (OPP) will be calculated using simultaneous MAP and IOP measurements. Optical coherence tomography angiography (OCTA) will be performed preoperatively and postoperatively to assess changes in peripapillary, optic nerve head, and macular microvascular parameters.
The primary objective is to compare changes in peripapillary vessel density between the two MAP target groups. Secondary objectives include evaluating changes in optic nerve head microvasculature, intraoperative OPP and IOP, and the relationships between the depth and duration of hypotension and OCTA-derived microvascular changes.
Read the detailed description
Controlled hypotension is commonly used during rhinoplasty to reduce intraoperative bleeding and improve surgical field visibility. However, reductions in mean arterial pressure (MAP) may also decrease ocular perfusion pressure (OPP), particularly when accompanied by changes in intraocular pressure (IOP). Although perioperative ischemic optic neuropathy is rare, hypotension and other factors that reduce tissue perfusion have been reported as potential contributors to perioperative visual complications. The effects of different controlled hypotension targets on ocular perfusion and optic nerve head microvasculature during rhinoplasty remain insufficiently characterized.
This prospective randomized controlled trial will include 60 patients aged 18-50 years with American Society of Anesthesiologists (ASA) physical status I-II who are scheduled for elective rhinoplasty or septorhinoplasty under general anesthesia. Participants will be randomized in a 1:1 ratio using computer-generated block randomization to one of two intraoperative controlled hypotension strategies: a target MAP of 50-60 mmHg or a target MAP of 60-70 mmHg. Participants and the ophthalmologist performing the postoperative OCTA assessment will be blinded to group allocation, whereas the attending anesthesiologist and surgeon will not be blinded.
All patients will receive standardized general anesthesia. MAP and other standard monitoring parameters will be continuously monitored. IOP will be measured noninvasively in the same eye using tonometry at predefined perioperative time points: before induction of anesthesia, after endotracheal intubation, after achieving the target MAP, 15 minutes after establishment of controlled hypotension, every 30 minutes thereafter during maintained hypotension, at the end of surgery, and during the early post-extubation period. MAP will be recorded simultaneously with each IOP measurement, and estimated OPP will be calculated as MAP minus IOP.
Optical coherence tomography angiography (OCTA) will be performed using the same device before surgery and during postoperative follow-up. Preoperative OCTA will be obtained 1-7 days before surgery, and postoperative assessments will be performed within 24-72 hours, at 1 week, and at 1 month. OCTA-derived parameters will include peripapillary vessel density, optic nerve head vessel density, and superficial and deep macular vascular density.
The primary outcome is the change in peripapillary vessel density from the preoperative measurement to the early postoperative assessment. Secondary outcomes include changes in optic nerve head and macular microvascular parameters, minimum intraoperative estimated OPP, maximum change in IOP, and the relationships between the depth and duration of controlled hypotension and postoperative OCTA-derived microvascular changes.
The study is designed to determine whether different MAP targets used during controlled hypotension are associated with different patterns of ocular perfusion and subclinical optic nerve head microvascular change. The study is not designed to determine the incidence of perioperative ischemic optic neuropathy or other rare postoperative visual complications.
- Being tested
- Lower MAP Target Strategy (50-60 mmHg), Higher MAP Target Strategy (60-70 mmHg)
- Keywords
- Controlled Hypotension, Mean Arterial Pressure, Ischemic Optic Neuropathy, Optic Nerve Perfusion, Intraocular Pressure
- Medical subject headings
- Optic Neuropathy, Ischemic
What participants receive
What participants receive. In a randomised study each person is assigned to one group by chance.
Lower MAP Target Strategy (50-60 mmHg)Other
Controlled hypotension will be maintained with a target mean arterial pressure (MAP) of 50-60 mmHg during general anesthesia. MAP will be continuously monitored, and anesthetic management will be titrated as clinically appropriate to maintain the assigned target range.
Higher MAP Target Strategy (60-70 mmHg)Other
Controlled hypotension will be maintained with a target mean arterial pressure (MAP) of 60-70 mmHg during general anesthesia. MAP will be continuously monitored, and anesthetic management will be titrated as clinically appropriate to maintain the assigned target range.
| Study group | Role | What they receive |
|---|---|---|
| Lower MAP Target (50-60 mmHg) | Experimental | Participants assigned to this group will undergo controlled hypotension during general anesthesia with a target mean arterial pressure (MAP) of 50-60 mmHg. Hemodynamic parameters will be continuously monitored, and the anesthetic regimen will be titrated to maintain MAP within the assigned target range while ensuring clinical safety. Receives: Other: Lower MAP Target Strategy (50-60 mmHg) |
| Higher MAP Target (60-70 mmHg) | Active comparator | Participants assigned to this group will undergo controlled hypotension during general anesthesia with a target mean arterial pressure (MAP) of 60-70 mmHg. Hemodynamic parameters will be continuously monitored, and the anesthetic regimen will be titrated to maintain MAP within the assigned target range while ensuring clinical safety. Receives: Other: Higher MAP Target Strategy (60-70 mmHg) |
What is being measured
The primary outcome is the main question the study is designed to answer.
Change in Peripapillary Vessel Density at 24-72 Hours After Surgery
Change in peripapillary vessel density measured by optical coherence tomography angiography (OCTA) from the preoperative baseline to 24-72 hours after surgery. Vessel density will be quantified using the same OCTA device and scanning protocol for all assessments. The primary comparison will be the difference in change from baseline between the two randomized MAP target groups.
Measured: Preoperative baseline (1-7 days before surgery) to 24-72 hours after surgery
Timeline
From the start of the study to its completion; the mark is today. Estimated dates are the sponsor’s plan.
- First posted21 Sep 2026
- Study start20 Sep 2026
- Primary completion1 Dec 2026 (estimated)
- Study completion15 Dec 2026 (estimated)
Resources
- Official record on ClinicalTrials.govThe registry entry this page is built from, with its full change history.
- Other trials for Controlled Hypotension for Nasal SurgeriesStudies 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
- Prevention
- Allocation
- Randomised
- Intervention model
- Parallel groups
- Model description
- Participants will be randomized in a 1:1 ratio to one of two parallel groups according to the target mean arterial pressure (MAP) during controlled hypotension: 50-60 mmHg or 60-70 mmHg. Each participant will remain in the assigned MAP target group throughout the intraoperative study period.
- Masking
- Double blind
- Who is masked
- Participant, Outcomes assessor
- Enrolment
- 60 participants (estimated)
Sponsor and investigators
- Lead sponsor
- Hitit University
- Sponsor type
- University, hospital or other
- Responsible party
- Principal investigator, Sibel Onen Ozdemir, Hitit University
IDs, dates and publications
- ClinicalTrials.gov ID
- NCT07832305
- Sponsor's protocol ID
- 2026-136
- Status last verified
- Oct 2026
- First submitted
- 16 Sep 2026
- Last updated
- 14 Oct 2026
- Results posted
- No
- Data monitoring committee
- No
- FDA-regulated drug
- No
- FDA-regulated device
- No
- Individual data sharing
- No: De-identified individual participant data that underlie the results reported in the published article may be made available upon reasonable request to the corresponding author. Data will be shared for scientifically sound research purposes, subject to approval by the study investigators and in accordance with applicable ethical and institutional requirements. No directly identifiable participant information will be shared.
Study at a glance
From the registry record, last updated by the sponsor on 14 Oct 2026. Recruitment status is as the sponsor reported it: confirm with the study team.
- Official title
- Effects of Different Mean Arterial Pressure Targets on Ocular Perfusion and OCTA-Derived Optic Nerve Head Microvasculature During Controlled Hypotension in Rhinoplasty: A Prospective Randomized Controlled Trial
- ClinicalTrials.gov ID
- NCT07832305
- Acronym / sponsor ID
- 2026-136
- Keywords
- Controlled Hypotension, Mean Arterial Pressure, Ischemic Optic Neuropathy, Optic Nerve Perfusion, Intraocular Pressure
- Study type
- Interventional
- Recruitment status
- Recruiting
- Enrolment
- 60 participants (estimated)
- Lead sponsor
- Hitit UniversityUniversity, hospital or other
- Study start
- 20 Sep 2026 (actual)
- Primary completion
- 1 Dec 2026 (estimated)
- Study completion
- 15 Dec 2026 (estimated)
- First posted
- 21 Sep 2026 (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.
This randomized controlled trial aims to evaluate the effects of two different mean arterial pressure (MAP) targets during controlled hypotension on ocular perfusion and optic nerve head microvasculature in patients undergoing elective rhinoplasty or septorhinoplasty.
A total of 60 patients will be randomized in a 1:1 ratio to a target MAP of either 50-60 mmHg or 60-70 mmHg during general anesthesia. Intraocular pressure (IOP) will be measured at predefined perioperative time points, and estimated ocular perfusion pressure (OPP) will be calculated using simultaneous MAP and IOP measurements. Optical coherence tomography angiography (OCTA) will be performed preoperatively and postoperatively to assess changes in peripapillary, optic nerve head, and macular microvascular parameters.
The primary objective is to compare changes in peripapillary vessel density between the two MAP target groups. Secondary objectives include evaluating changes in optic nerve head microvasculature, intraoperative OPP and IOP, and the relationships between the depth and duration of hypotension and OCTA-derived microvascular changes.
Detailed description
Controlled hypotension is commonly used during rhinoplasty to reduce intraoperative bleeding and improve surgical field visibility. However, reductions in mean arterial pressure (MAP) may also decrease ocular perfusion pressure (OPP), particularly when accompanied by changes in intraocular pressure (IOP). Although perioperative ischemic optic neuropathy is rare, hypotension and other factors that reduce tissue perfusion have been reported as potential contributors to perioperative visual complications. The effects of different controlled hypotension targets on ocular perfusion and optic nerve head microvasculature during rhinoplasty remain insufficiently characterized.
This prospective randomized controlled trial will include 60 patients aged 18-50 years with American Society of Anesthesiologists (ASA) physical status I-II who are scheduled for elective rhinoplasty or septorhinoplasty under general anesthesia. Participants will be randomized in a 1:1 ratio using computer-generated block randomization to one of two intraoperative controlled hypotension strategies: a target MAP of 50-60 mmHg or a target MAP of 60-70 mmHg. Participants and the ophthalmologist performing the postoperative OCTA assessment will be blinded to group allocation, whereas the attending anesthesiologist and surgeon will not be blinded.
All patients will receive standardized general anesthesia. MAP and other standard monitoring parameters will be continuously monitored. IOP will be measured noninvasively in the same eye using tonometry at predefined perioperative time points: before induction of anesthesia, after endotracheal intubation, after achieving the target MAP, 15 minutes after establishment of controlled hypotension, every 30 minutes thereafter during maintained hypotension, at the end of surgery, and during the early post-extubation period. MAP will be recorded simultaneously with each IOP measurement, and estimated OPP will be calculated as MAP minus IOP.
Optical coherence tomography angiography (OCTA) will be performed using the same device before surgery and during postoperative follow-up. Preoperative OCTA will be obtained 1-7 days before surgery, and postoperative assessments will be performed within 24-72 hours, at 1 week, and at 1 month. OCTA-derived parameters will include peripapillary vessel density, optic nerve head vessel density, and superficial and deep macular vascular density.
The primary outcome is the change in peripapillary vessel density from the preoperative measurement to the early postoperative assessment. Secondary outcomes include changes in optic nerve head and macular microvascular parameters, minimum intraoperative estimated OPP, maximum change in IOP, and the relationships between the depth and duration of controlled hypotension and postoperative OCTA-derived microvascular changes.
The study is designed to determine whether different MAP targets used during controlled hypotension are associated with different patterns of ocular perfusion and subclinical optic nerve head microvascular change. The study is not designed to determine the incidence of perioperative ischemic optic neuropathy or other rare postoperative visual complications.
Study design
- Primary purpose
- Prevention
- Allocation
- Randomised
- Intervention model
- Parallel groups
- Masking
- Double blind (participant, outcomes assessor)
- Number of arms
- 2
- Model description
- Participants will be randomized in a 1:1 ratio to one of two parallel groups according to the target mean arterial pressure (MAP) during controlled hypotension: 50-60 mmHg or 60-70 mmHg. Each participant will remain in the assigned MAP target group throughout the intraoperative study period.
| Arm | Type | Receives |
|---|---|---|
| Lower MAP Target (50-60 mmHg) | Experimental | Other: Lower MAP Target Strategy (50-60 mmHg)Participants assigned to this group will undergo controlled hypotension during general anesthesia with a target mean arterial pressure (MAP) of 50-60 mmHg. Hemodynamic parameters will be continuously monitored, and the anesthetic regimen will be titrated to maintain MAP within the assigned target range while ensuring clinical safety. |
| Higher MAP Target (60-70 mmHg) | Active comparator | Other: Higher MAP Target Strategy (60-70 mmHg)Participants assigned to this group will undergo controlled hypotension during general anesthesia with a target mean arterial pressure (MAP) of 60-70 mmHg. Hemodynamic parameters will be continuously monitored, and the anesthetic regimen will be titrated to maintain MAP within the assigned target range while ensuring clinical safety. |
Who may qualify
- Ages
- 18 years and older
- Sex
- All
- Healthy volunteers
- Not accepted
- Age groups
- Adult, Older adult
Key inclusion criteria (4 listed)
- Age 18-50 years
- Scheduled for elective rhinoplasty or septorhinoplasty
- American Society of Anesthesiologists (ASA) physical status I-II
- Willing and able to provide written informed consent
Key exclusion criteria (10 listed)
- History of glaucoma, retinal disease, optic neuropathy, or other significant ophthalmologic disease
- Previous ocular surgery
- High myopia
- Uncontrolled hypertension, diabetes mellitus, or other serious systemic disease
- ASA physical status III or higher
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 |
|---|---|---|
| Lower MAP Target Strategy (50-60 mmHg)Controlled hypotension will be maintained with a target mean arterial pressure (MAP) of 50-60 mmHg during general anesthesia. MAP will be continuously monitored, and anesthetic management will be titrated as clinically appropriate to maintain the assigned target range. | Other | Lower MAP Target (50-60 mmHg) |
| Higher MAP Target Strategy (60-70 mmHg)Controlled hypotension will be maintained with a target mean arterial pressure (MAP) of 60-70 mmHg during general anesthesia. MAP will be continuously monitored, and anesthetic management will be titrated as clinically appropriate to maintain the assigned target range. | Other | Higher MAP Target (60-70 mmHg) |
Primary outcome
Change in Peripapillary Vessel Density at 24-72 Hours After Surgery
Time frame: Preoperative baseline (1-7 days before surgery) to 24-72 hours after surgery
Change in peripapillary vessel density measured by optical coherence tomography angiography (OCTA) from the preoperative baseline to 24-72 hours after surgery. Vessel density will be quantified using the same OCTA device and scanning protocol for all assessments. The primary comparison will be the difference in change from baseline between the two randomized MAP target groups.
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 14 Oct 2026.
- Individual participant dataSharing planned: No. De-identified individual participant data that underlie the results reported in the published article may be made available upon reasonable request to the corresponding author. Data will be shared for scientifically sound research purposes, subject to approval by the study investigators and in accordance with applicable ethical and institutional requirements. No directly identifiable participant information will be shared.
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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.
1 site in 1 country: see every site and its status.
Questions about this trial
What is this clinical trial studying?
A study testing Lower MAP Target Strategy (50-60 mmHg) and Higher MAP Target Strategy (60-70 mmHg) in people with Controlled Hypotension for Nasal Surgeries, run by Hitit University at 1 site in Turkey (Türkiye).
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 4 inclusion and 10 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: looking for participants now, as of the sponsor's last update on 14 Oct 2026. Status can change between updates, so confirm with the study contact before making plans.
Where is the study taking place?
The record lists 1 site in Turkey (Türkiye). 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 Sibel ÖNEN ÖZDEMİR (+905442892194, sibelonen89@gmail.com), or a site near the patient. AzTrials does not enrol participants or take referrals.
What does the primary outcome measure?
Change in Peripapillary Vessel Density at 24-72 Hours After Surgery (time frame: Preoperative baseline (1-7 days before surgery) to 24-72 hours after surgery). 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 14 Oct 2026.