Pre-anesthetic Ultrasonographic Assessment of Neck Vessels as Predictors of Spinal Anesthesia Induced Hypotension in Elderly: a Prospective Observational Study.
Trial Snapshot
- Phase
- Not Applicable
- Status
- Completed
- Sponsor
- Cairo University
- Enrollment
- 71
- Locations
- 1
- Primary Endpoint
- Accuracy of IJV collapsibility index as predictor of Spinal anesthesia induced hypotension.
Study 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.
Study Design
- Study Type
- Observational
- Observational Model
- Cohort
- Time Perspective
- Prospective
Eligibility Criteria
- Ages
- 60 Years to 90 Years (Adult, Older Adult)
- Sex
- All
- Accepts Healthy Volunteers
- No
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)
Investigators
Bassant M. Abdelhamid
Associate professor
Cairo University