Measurement of breathing muscle movement using ultrasound before abdominal surgery

Not yet recruiting

• Conditions: Generalized (acute) peritonitis,

• Registration Number: CTRI/2019/02/017881
• Lead Sponsor: JIPMER

Brief Summary

After obtaining approval from Postgraduate researchmonitoring committee (PGRMC), Institute ethics committee, and completing CTRIregistration, patients satisfying eligibility criteria will be selected byconsecutive sampling technique. Written informed consent explaining about theprocedure, risks and any adverse events will be obtained before being enrolledinto the study.

The attendinganesthesiologist will do a thorough preoperative assessment and history on durationof illness will be obtained. Patients will be shifted in to the OT table andall standard monitors will be attached and baseline parameters will be recorded.(PR,SBP, ECG). Pulmonary function test will be performed using a bedside spirometerand the parameters like Tidal volume(TV), Vital capacity(VC), forced vitalcapacity(FVC), forced expiratory volume (FEV1) and peak expiratory flow rate(PEFR) will be recorded in supine position. An experienced anaesthesiologistwill visualize the diaphragm using a curvilinear probe of high resolutionportable ultrasound machine. In 2- dimensional mode, the probe will beplaced on the right anterior axillary lines at the level of 8th to10th intercostal space to achieve the best view of thehemidiaphragm. Patient will be asked to take deep inspiration and the movementof the hemidiaphragm will be recorded on M-mode sonography at zone ofopposition. During M-mode imaging, the normally functioning diaphragm isrepresented as an echogenic line that moves freely during inspiration andexpiration. Inspiration is identified on the sonographic tracing as an upwardflexion and expiration will be identified as downward flexion.

 Diaphragmaticexcursion will be measured by the vertical distance between the upward flexionat the end of inspiration and downward flexion at the end of expiration ie, thevertical distance between the bottom and the peak of the tracing line; Thisvertical distance represents diaphragmatic excursion. Diaphragm thicknesswill be estimated as the vertical distance between the pleural and peritoneallayers at the end of expiration. Parameters like repiratory rate, arterialblood gas analysis(ABG) and abdominal girth will be measured before induction.General anaesthesia will be induced as per departmental protocol. At the end ofthe surgery, duration of surgery and whether patient was extubated or not willbe noted. If not extubated, duration of mechanical ventilation will be noted.

Detailed Description

Not available

Study Timeline

• Study Start: 2019-01-05
• Last Update Posted: 2019-02-22

Recruitment & Eligibility

• Status: Not Yet Recruiting
• Sex: All
• Target Recruitment: 80

Inclusion Criteria

• 1.Patients with perforation peritonitis scheduled for emergency laparotomy under general anaesthesia 2.Age 18-60 yrs.
• 3.American society of Anaesthesiologists(ASA) classification 1 – 3 patients.

Exclusion Criteria

1.History of neuromuscular disease 2.Pneumothorax or pneumomediastinum 3.Intubated patients 4.Patients with pre-existing pulmonary disease.

Study & Design

• Study Type: Observational
• Study Design: Not specified

Primary Outcome Measures

Name	Time	Method
To measure diaphragmatic excursion using preoperative ultrasound	Before Induction of Anaesthesia

Secondary Outcome Measures

Name	Time	Method
To measure diaphragmatic thickness using preoperative ultrasound	Before Induction of Anaesthesia

Trial Locations

Locations (1)

JIPMER; 🇮🇳 Pondicherry, PONDICHERRY, India

JIPMER

🇮🇳Pondicherry, PONDICHERRY, India

Jayaram I

Principal investigator

9498874256

i.jayaram11@gmail.com