Evaluation of Transcranial Doppler Vasoconstrictor Vasoreactivity During General Anesthesia in Hypertensive Patients
试验速览
- 阶段
- 不适用
- 状态
- 撤回
- 主要终点
- Variation of the velocity of the middle cerebral artery with vasoconstrictors and during a modification of EtCO2.
研究概览
简要总结
During a general anesthesia, people over 65 years old and hypertensive, have a modification of the vasoreactivity and their cerebral blood flow under vasoconstrictor such as norepinephrine or phenylephrine. We study the variation of the average velocity of the average cerebral artery under vasoconstrictor and during a modification of End Tidal CO2 (EtCO2) by transcranial Doppler.
详细描述
General anesthesia induces a sympathetic block frequently leading to hypotension, especially in elderly and hypertensive patients. Currently, Phenylephrine (PE) and Norepinephrine (NE) are commonly used in clinical practice to address this arterial pressure drop. Their cardiovascular effects are not exactly the same, even though they both increase mean blood pressure.
Maintenance of mean arterial pressure is not the only hemodynamic goal during general anesthesia in the elderly. Cognitive disorders have been demonstrated during post-anesthetic awakening.
Cerebral hemodynamics is assessed by analyzing the speed of blood flow in the middle cerebral artery using transcranial Doppler (DTC). It measures the systolic and diastolic speed as well as the pulsatility index, which are predictive factors for lowering cerebral blood flow.
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
- 65 Years 至 —（Older Adult）
- 性别
- All
- 接受健康志愿者
- 否
入选标准
- •older over 65 years
- •high blood pressure disease
- •need general anesthesia
- •need vasopressors : norepinephrine or phenylephrine
- •temporal window of transcranial doppler is viable
排除标准
- •Acute, valvular, rhythmic or ischemic cardiovascular pathology
- •severe arthritis (stage 3)
- •Intra-cranial pathology
- •Significant carotid stenosis (> 40%) or carotid endarterectomy
- •Cervical surgery
- •Taking a premedication that can modify cerebral vasoreactivity
- •Insulin-dependent diabetes for more than 10 years
- •Person under judicial protection
- •Opposition to data processing
结局指标
主要结局
Variation of the velocity of the middle cerebral artery with vasoconstrictors and during a modification of EtCO2.
时间窗: 48 hours
Measurements from transcranial doppler velocity of the middle cerebral artery
次要结局
- Variation of cardiac output with vasoconstrictors and during modification of EtCO2.(48 hours)