Postoperative Incidence of Orthostatic Intolerance and Hypotension in Patients Undergoing Primary Unicompartmental Knee Arthroplasty (UKA)
试验速览
- 阶段
- 不适用
- 发起方
- 入组人数
- 42
- 试验地点
- 1
- 主要终点
- Incidence of orthostatic intolerance
研究概览
简要总结
Incidence and pathophysiologic hemodynamics of orthostatic intolerance and orthostatic hypotension in patients undergoing UKA
详细描述
In today's multimodal fast-track perioperative care program (ERAS) early mobilization is an essential cornerstone, and is known to prevent postoperative morbidity and lower length of stay in the hospital. Intact orthostatic blood pressure regulation is necessary to complete mobilization, and postoperative orthostatic hypotension (OH), defined as a drop in systolic arterial pressure (SAP) > 20 mmHg or a drop >10 mmHg in diastolic arterial pressure (DAP) and orthostatic intolerance (OI), characterized by dizziness, nausea, feeling warm and syncope related to orthostatic challenge, are well-known reasons for delayed early mobilization, prolonged bedrest and delayed ambulation.
Former studies have been accessing the postoperative incidence in THA-patients (22%-40%), TKA-patients(36%), colorectal patients(53%), abdominal and cardiothoracic surgery patients(40%), radical prostatectomy patients (50%). One study have been accessing the postoperative incidence of OI in mastectomy patients and found an incidence of 4%, and thereby indicating that postoperative OI is not an issue in minor surgery.
This study is the first, to our acknowledgement, which accesses the postoperative incidence of OI/OH in UKA-patients.
研究设计
- 研究类型
- Observational
- 观察模型
- Cohort
- 时间视角
- Prospective
入排标准
- 年龄范围
- 18 Years 至 —（Adult, Older Adult）
- 性别
- All
- 接受健康志愿者
- 否
入选标准
- •Age >18 years and
- •Patients undergoing UKA in spinal anesthesia at Hvidovre Hospital in a standardized fast-track setting.
- •Patients that speak and understand Danish
- •Written informed consent
排除标准
- •Pre-existing orthostatic hypotension or intolerance
- •Alcohol or substance abuse
- •everyday treatment with either anxiolytic or antipsychotic medicine
- •Cognitive dysfunction
- •If surgery was converted to general anesthesia or total knee arthroplasty.
结局指标
主要结局
Incidence of orthostatic intolerance
时间窗: 6 hours postoperatively
Symptoms of orthostatic intolerance: dizziness, nausea, vomiting, blurry vision or syncope during mobilization
Incidence of orthostatic hypotension
时间窗: 6 hours postoperatively
Orthostatic hypotension is defined as a fall in systolic pressure \> 20 mmHg and/or diastolic pressure \> 10 mmHg during mobilization
次要结局
- Changes in systolic arterial pressure (SAP) during mobilization(Preoperatively, 6 and 24 hours postoperatively)
- Changes in diastolic arterial pressure (DAP) during mobilization(Preoperatively, 6 and 24 hours postoperatively)
- Changes in mean arterial pressure (MAP) during mobilization(Preoperatively, 6 and 24 hours postoperatively)
- Changes in cardiac output (CO) during mobilization(Preoperatively, 6 and 24 hours postoperatively)
- Changes in systemic vascular resistance (SVR) during mobilization(Preoperatively, 6 and 24 hours postoperatively)
- Changes in stroke volume (SV) during mobilization(Preoperatively, 6 and 24 hours postoperatively)
- Changes in heart rate variability (HRV) during mobilization(Preoperatively, 6 and 24 hours postoperatively)
- Changes in peripheral perfusion index (PPI) during mobilization(Preoperatively, 6 and 24 hours postoperatively)
- Changes in cerebral perfusion (ScO2) during mobilization(Preoperatively, 6 and 24 hours postoperatively)
- Changes in muscular perfusion (SmO2) during mobilization(Preoperatively, 6 and 24 hours postoperatively)
- Changes in haemoglobin (Hgb) concentration(Preoperatively, 6 and 24 hours postoperatively)
- Changes in C-Reactive Protein(Preoperatively, 6 and 24 hours postoperatively)
研究者
Louise Bundsgaard Andersen
Undergraduate Student
Copenhagen University Hospital, Hvidovre