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Trial registered on ANZCTR
Registration number
ACTRN12621000408886
Ethics application status
Approved
Date submitted
27/12/2019
Date registered
15/04/2021
Date last updated
28/07/2022
Date data sharing statement initially provided
15/04/2021
Type of registration
Retrospectively registered
Titles & IDs
Public title
The effect of different fresh gas flow values on myocardial repolarization parameters in patients for rhinoplasty operation
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Scientific title
The effect of different fresh gas flow values on myocardial repolarization parameters in patients for rhinoplasty operation
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Secondary ID [1]
299980
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None
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Universal Trial Number (UTN)
U1111-1245-8404
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Trial acronym
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Linked study record
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Health condition
Health condition(s) or problem(s) studied:
Rhinoplasty operation
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Myocardial repolarization
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Condition category
Condition code
Anaesthesiology
313743
313743
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0
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Anaesthetics
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Cardiovascular
313744
313744
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0
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Normal development and function of the cardiovascular system
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Intervention/exposure
Study type
Interventional
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Description of intervention(s) / exposure
Patients undergoing rhinoplasty operation will be randomized to receive either low flow anesthesia or normal flow anesthesia groups. Randomisation will be performed with the closed envelope method. Drug interventions will be performed by anaesthetist. Anesthesia induction will be performed with propofol 2mg/kg and fentanyl 1µg/kg. Each group will be given desflurane (50% oxygen and 50% air mixture with 6% desflurane) as an inhaler anesthetic agent. Normal flow anesthesia will be defined as follows: the fresh gas flow was administered at 4-6 L/min for the first 6-8 minutes. After seeing minimum alveolar concentration achieved to +1 on anesthesia device, fresh gas flow rate will be reduced to 2 L/min (fresh gas flow rate: 2 L/min). Low flow anesthesia will be defined as follows: the fresh gas flow was administered at 4-6 L/min for the first 6-8 minutes. After seeing minimum alveolar concentration achieved to +1 on anesthesia device, fresh gas flow rate was reduced to 0.5 L/min (fresh gas flow rate: 0.5 L/min). Desflurane volume will be adjusted according to the MAC 1 in both groups during anesthesia maintenance. The fidelity of of intervention will be assessed by device analytics.
12-lead electrocardiography (ECG) will be taken from all patients during the operation by anaesthetist. In addition, oxygen saturation, heart rate, noninvasive systolic-diastolic blood pressure, total desflurane intake and total consumption, carbon dioxide inspiratory and expiratory concentration, inspiratory and expiratory oxygen values, and oxygen uptake will be monitored during the operation. Hemodynamic data and gas concentration values will be recorded on the monitor preoperatively, after induction, immediately after intubation, at 1, 5, 10 minutes after intubation, and every 5 minutes thereafter and after extubation.
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Intervention code [1]
316246
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Treatment: Drugs
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Comparator / control treatment
The comparator is low flow desflurane anesthesia.
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Control group
Dose comparison
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Outcomes
Primary outcome [1]
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Myocardial repolarization
Myocardial repolarization will be assessed with QT interval, T peak to end interval and frontal QRS-T angle. These parameters will be assessed from the 12-lead surface electrocardiography (Nihon Kohden, Tokyo, Japan).
QT interval will be measured from the beginning of the QRS complex to the end of T wave.
T peak to end interval will be measured as the interval from the peak of a T wave to the end of T wave.
Frontal QRS-T angle will be measured as the absolute value of the difference between QRS and T wave axes.
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Assessment method [1]
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Timepoint [1]
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The following evaluation time points weill be defined for the QT interval, T peak to end interval and frontal QRS-T angle. T1: Pre-operative (basal), T2: immediately after anesthesia induction, T3: immediately after endotrakeal intubation, T4: 5 min. after endotracheal intubation, T5: 15 min. after endotracheal intubation, T6: 30 min. after endotracheal intubation, T7: 60 min. after endotracheal intubation, T8: immediately after extubation, T9: 15 min after extubation
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Secondary outcome [1]
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Mean arterial pressure (MAP).
Patients will monitored and systolic blood pressure (SBP) and diastolic blood pressure (DBP) were measured with automatic sphygmomanometer. MAP will automatically calculated from SBP and DBP vales by patient monitoring.
Its formula was as follows: [(2 x DBP) + SBP] / 3.
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Assessment method [1]
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Timepoint [1]
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The following evaluation time points weill be defined for the MAP. T1: Pre-operative (basal), T2: immediately after anesthesia induction, T3: immediately after endotrakeal intubation, T4: 5 min. after endotracheal intubation, T5: 15 min. after endotracheal intubation, T6: 30 min. after endotracheal intubation, T7: 60 min. after endotracheal intubation, T8: immediately after extubation, T9: 15 min after extubation
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Secondary outcome [2]
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Heart rate (HR).
Patients will be monitored and heart rate will be obtained from this monitoring.
Heart rate will be defined as number of beats per minute.
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Assessment method [2]
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Timepoint [2]
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The following evaluation time points weill be defined for the HR. T1: Pre-operative (basal), T2: immediately after anesthesia induction, T3: immediately after endotrakeal intubation, T4: 5 min. after endotracheal intubation, T5: 15 min. after endotracheal intubation, T6: 30 min. after endotracheal intubation, T7: 60 min. after endotracheal intubation, T8: immediately after extubation, T9: 15 min after extubation
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Eligibility
Key inclusion criteria
Patients undergoing rhinoplasty operation and aging between 18-65 years, with American Society of Anaesthesiologist (ASA) grades I or II will be included in this randomized study.
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Minimum age
18
Years
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Maximum age
65
Years
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Sex
Both males and females
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Can healthy volunteers participate?
No
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Key exclusion criteria
ASA grades III or higher; previous history of hepatic, renal or cardiovascular diseases; known allergy to any of the used medications; pregnant patients; patients with electrolyte imbalance;, those using drugs that may affect myocardial repolarization (antiarrhythmic, beta-blocker, positive inotropic agent, tricyclic antidepressant, phenotiazine); bundle branch block on ECG; diabetes mellitus or other endocrine disorder; patients who develop laryngospasm during induction
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Study design
Purpose of the study
Treatment
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Allocation to intervention
Randomised controlled trial
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Procedure for enrolling a subject and allocating the treatment (allocation concealment procedures)
Sealed opaque envelopes
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Methods used to generate the sequence in which subjects will be randomised (sequence generation)
Simple randomisation using a randomisation table created by computer software
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Masking / blinding
Open (masking not used)
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Who is / are masked / blinded?
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Intervention assignment
Parallel
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Other design features
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Phase
Not Applicable
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Type of endpoint/s
Safety
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Statistical methods / analysis
SPSS for Windows 24.0 program will be used for statistical analysis. Continuous variables will be given as mean ± standard deviation or median (25-75 IQR) and categorical variables will be given as percentage. Kolmogorov-Smirnov test will be used to test the normality of data. Comparison of continuous variables will be performed with Student t test or Mann-Whitney-U test according to the normality test. Chi-square test will be used to compare categorical variables. Pearson’s or Sperman correlation coefficient will be used for correlation analysis. Variables found to be p <0.1 in univariate analysis will be included in the multivariate analysis. p <0.05 will be considered statistically significant.
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Recruitment
Recruitment status
Completed
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Date of first participant enrolment
Anticipated
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Actual
1/03/2021
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Date of last participant enrolment
Anticipated
30/04/2021
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Actual
30/06/2021
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Date of last data collection
Anticipated
30/04/2021
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Actual
30/06/2021
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Sample size
Target
80
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Accrual to date
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Final
80
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Recruitment outside Australia
Country [1]
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Turkey
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State/province [1]
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SANLIURFA
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Funding & Sponsors
Funding source category [1]
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Hospital
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Name [1]
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Sanliurfa Mehmet Akif Inan Training and Research Hospital
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Address [1]
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Esentepe, Ertugrul Street. 132 A, 63040 Sanliurfa City Center / Haliliye / Sanliurfa Province
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Country [1]
304438
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Turkey
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Primary sponsor type
Hospital
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Name
Sanliurfa Mehmet Akif Inan Training and Research Hospital
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Address
Esentepe, Ertugrul Street. 132 A, 63040 Sanliurfa City Center / Haliliye / Sanliurfa Province
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Country
Turkey
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Secondary sponsor category [1]
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None
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Name [1]
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Address [1]
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Country [1]
304887
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Ethics approval
Ethics application status
Approved
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Ethics committee name [1]
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Harran university clinical research ethics committee
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Ethics committee address [1]
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Harran University, Osmanbey Campus ,Mardin Street, 18A, postal code: 63300, Haliliye/Sanliurfa Province
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Ethics committee country [1]
304873
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Turkey
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Date submitted for ethics approval [1]
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04/10/2019
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Approval date [1]
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14/10/2019
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Ethics approval number [1]
304873
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03/10
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Summary
Brief summary
Recently, novel anesthesia techniques have developed and low-flow anesthesia method has become to gain more interest worldwide. In contrast to normal flow anesthesia where the flow of gas to the breathing system is between 2 L min-1, low flow anesthesia where the flow of gas is less than or equal to 1 L min-1 aims to give at least 50% of oxygen to the patient with sufficient proportion of volatile anesthetic agent to meet the need of the body after CO2 is separated from the gas expired from the patient. The most important advantages of this novel anesthesia technique are reduced cost because of decreased volatile anesthetic gas consumption and less air pollution. Desflurane is one of the most used volatile anesthetic agents in clinical practice. Because desflurane is less soluble in blood and tissues, has a wide range for performing doses and is titrated easily and rapidly, it can be used as optimal volatile anesthetic agent for low flow anesthesia. Myocardial repolarization can be evaluated by QT interval and T peak to T end interval on surface ECG. Studies showed that increased QT and T peak to T end interval was associated with poor prognosis in cardiovascular diseases. We hypothesized that low flow desflurane anesthesia may has lower cardiac adverse effect than normal flow desflurane anesthesia. Although it is known that normal flow desflurane anesthesia increases the duration of myocardial repolarization, the effect of low flow desflurane anesthesia on myocardial repolarization is not clear. In this study, we aimed to investigate the effect of low flow and normal flow desflurane anesthesia on QT and T peak to T end interval.
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Trial website
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Trial related presentations / publications
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Public notes
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Contacts
Principal investigator
Name
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Dr Tugba Bingol Tanriverdi
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Address
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Esentepe, Ertugrul Street. 132 A, 63040 Sanliurfa City Center / Haliliye / Sanliurfa Province
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Country
98486
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Turkey
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Phone
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+905418842232
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Fax
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Email
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[email protected]
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Contact person for public queries
Name
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MEHMET TERCAN
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Address
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Esentepe, Ertugrul Street. 132 A, 63040 Sanliurfa City Center / Haliliye / Sanliurfa Province
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Country
98487
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Turkey
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Phone
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+905323445635
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Fax
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Email
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[email protected]
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Contact person for scientific queries
Name
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Zulkif Tanriverdi
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Address
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Harran University, Osmanbey Campus ,Mardin Street, 18A, postal code: 63300, Haliliye/Sanliurfa Province
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Country
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Turkey
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Phone
98488
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+905068823335
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Fax
98488
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Email
98488
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[email protected]
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Data sharing statement
Will individual participant data (IPD) for this trial be available (including data dictionaries)?
Yes
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What data in particular will be shared?
All of the individual participant data collected during the tria will be shared.
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When will data be available (start and end dates)?
Beginning 3 months and no end date determined
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Available to whom?
anyone who wishes to access it.
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Available for what types of analyses?
any purpose
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How or where can data be obtained?
access subject to approvals by Principal Investigator (e-mail:
[email protected]
)
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What supporting documents are/will be available?
No Supporting Document Provided
Results publications and other study-related documents
Documents added manually
No documents have been uploaded by study researchers.
Documents added automatically
Source
Title
Year of Publication
DOI
Dimensions AI
The Effect of Low-Flow and Normal-Flow Desflurane Anesthesia on the Frontal QRS-T Angle in Patients Undergoing Rhinoplasty Operation: A Randomized Prospective Study
2022
https://doi.org/10.7759/cureus.28920
N.B. These documents automatically identified may not have been verified by the study sponsor.
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