The Dynamic Effects of Phenylephrine on Preload and Cardiac Output in Patients Under General Anaesthesia
试验速览
- 阶段
- 4 期
- 状态
- 已完成
- 发起方
- 入组人数
- 26
- 试验地点
- 1
- 主要终点
- Cardiac output
研究概览
简要总结
In patients under general anesthesia, episodes of hypotension are often treated with phenylephrine. The effect of phenylephrine is conventionally attributed to afterload increase.
The aim of the study is to describe the time course of the effects of phenylephrine on the cardiac preload and cardiac output, and to evaluate whether phenylephrine, as an exclusive alpha-mimetic, could be beneficial for preload optimisation.
详细描述
In consecutive patients scheduled for laparoscopic sigmoidectomy, all hemodynamic and respiratory variables are recorded electronically for subsequent offline analysis.
All patients are ventilated in volume control mode with a tidal volume of 8 ml/kg ideal body weight.
During steady-state Target Controlled Infusion (TCI) propofol/remifentanil anesthesia, when the Mean Arterial Blood Pressure (MAP) dropped below 80% of the awake state for at least 5 minutes, a phenylephrine bolus of 2 μg/kg is administered. If necessary this is repeated, or a continuous administration of phenylephrine is started at a rate of 10-30 μg/kg/u.
All patient manipulations during the procedure are electronically recorded and time stamped for subsequent off-line data analysis.
The first episode in each patient where phenylephrine is administered and in a period of at least 10 minutes when minimal or absent patient manipulation occurred, the hemodynamic variables are analysed to describe the effects of phenylephrine administration on the dynamic preload parameters and macro-hemodynamics.
研究设计
- 研究类型
- Interventional
- 分配方式
- Na
- 干预模型
- Single Group
- 主要目的
- Treatment
- 盲法
- None
入排标准
- 年龄范围
- 18 Years 至 85 Years（Adult, Older Adult）
- 性别
- All
- 接受健康志愿者
- 否
入选标准
- •necessity for arterial blood pressure monitoring
- •necessity for central venous blood pressure monitoring
排除标准
- •unwilling or unable to grant written informed consent
- •cardiac arrythmia
- •contra-indication for phenylephrine
- •contra-indications for atropine
- •contra-indication for Total Intravenous Anesthesia
研究组 & 干预措施
Patient receiving phenylephrine 2ug/kg
phenylephrine 2ug/kg in case of hypotension
干预措施: Phenylephrine (Drug)
结局指标
主要结局
Cardiac output
时间窗: perioperative
The evolution of the Cardiac Output in a time course \<20 minutes after administration
次要结局
- Pulse Pressure Variation(perioperative)
- End-Tidal CO2(perioperative)
- Arterial Blood Pressure(perioperative)
- central venous pressure(perioperative)
研究者
Dr. Alain Kalmar, MD, PhD
Dr
Algemeen Ziekenhuis Maria Middelares