Pre-anesthetic Ultrasonographic Assessment of Neck Vessels as Predictors of Spinal Anesthesia Induced Hypotension in Elderly: a Prospective Observational Study.
Overview
- Phase
- N/A
- Intervention
- Not specified
- Conditions
- Post-spinal Hypotension
- Sponsor
- Cairo University
- Enrollment
- 71
- Locations
- 1
- Primary Endpoint
- Accuracy of IJV collapsibility index as predictor of Spinal anesthesia induced hypotension.
- Status
- Completed
- Last Updated
- 4 years ago
Overview
Brief Summary
Spinal anesthesia induces sympathetic blockade and venodilation, thus reducing venous return and the cardiac output. Therefore, assessment of intravascular volume deficit before anesthesia might predict a critical decrease in blood pressure after anesthesia.
Recently, ultrasonographic evaluation of the internal jugular vein (IJV) has been used to reflect intravascular volume status and fluid and as a predictor of hypotension after induction of general anesthesia.
Carotid intima-media thickness (CIMT) has been used to predict atherosclerosis-related events, such as stroke, myocardial infarction, peripheral artery disease, and hypotension after induction of anesthesia with a cut-off value of 0.65 mm of CIMT as a threshold level.
Detailed Description
This study aims to evaluate the ability of preoperative Ultrasonographic assessment of the internal jugular vein (IJV) and Carotid intima-media thickness (CIMT) to predict spinal anesthesia induced hypotension (SAIH). Participants will be elderly patients (above 60 years), ASA I-II-III, scheduled for elective surgeries under spinal anesthesia.
Investigators
Bassant M. Abdelhamid
Associate professor
Cairo University
Eligibility Criteria
Inclusion Criteria
- •Adult patients (\>60 years)
- •ASA I-II-III
- •Patients scheduled for elective surgeries under spinal anesthesia.
Exclusion Criteria
- •Operations which will last for less than 15 minutes.
- •Deep vein thrombosis in the upper extremities.
- •History of radiotherapy or neck surgery.
- •Previous sonographic data show tricuspid or mitral regurgitation or a very distended right atrium and ventricle.
- •Patients with history of valvular or carotid artery surgery, arrhythmia, heart failure.
- •Being unable to lie in a supine position for the necessary measurements.
- •Technical limitations to imaging of the IJV and carotid artery.
Outcomes
Primary Outcomes
Accuracy of IJV collapsibility index as predictor of Spinal anesthesia induced hypotension.
Time Frame: 10 minutes
(Area under receiver operating characteristic curves)
Secondary Outcomes
- Accuracy of rate of change in IJV area with change in posture as a predictor of Spinal anesthesia induced hypotension.(10 minutes)
- Carotid intima media thickness.(10 minutes)
- Norepinephrine consumption(20 minutes)
- Incidence of Spinal anesthesia induced hypotension(20 minutes)