Cardiac Output and Other Hemodynamic Changes With Prone Position in Cervical Myelopathy Patients Undergoing Surgery
Overview
- Phase
- Not Applicable
- Intervention
- Not specified
- Conditions
- Hemodynamics Instability
- Sponsor
- Dhritiman Chakrabarti
- Enrollment
- 30
- Primary Endpoint
- Mean arterial pressure
- Status
- Completed
- Last Updated
- 9 years ago
Overview
Brief Summary
Positioning a patient in prone position under anaesthesia significantly alters cardiovascular physiology. Cervical myelopathy patients are known to have autonomic dysfunction. Such patients when positioned in prone position under anaesthesia carry a higher risk of developing hemodynamic changes and this can compromise spinal cord perfusion.
This prospective observational study was conducted on 30 patients with cervical myelopathy who underwent surgery in prone position at NIMHANS, Bangalore hospital. The non invasive cardiac output monitor (NICOM, Cheetah Medicals) was used to record various hemodynamic parameters. The hemodynamic parameters were recorded at baseline, post induction, post intubation, prior to prone position, post prone position, and every five minutes thereafter upto 20mins.
The hemodynamic parameters that were recorded using the NICOM monitor:
- HR - Heart rate (beats /min)
- NIBP - non invasive blood pressure (mmHg)
- MAP - mean arterial pressure(mmHg)
- CO - cardiac output (l/min)
- CI - cardiac index (l/min/m2)
- SV - Stroke volume (ml/beat)
- SVV -stroke volume variability (%)
- TPR - total peripheral resistance (dynes. sec/cm5)
Investigators
Dhritiman Chakrabarti
Assistant Professor of Neuroanaesthesiology
National Institute of Mental Health and Neuro Sciences, India
Eligibility Criteria
Inclusion Criteria
- •Cervical myelopathy patients undergoing surgery in prone position with:
- •ASA Class I , II and III
- •Age between 18 to 65 years
- •Nurick's grade 2 or more
Exclusion Criteria
- •Atlanto occipital dislocation and cervicomedullary junction pathology
- •Tumour pathology
- •Diabetic patients
- •Patients positioned prone in the awake state (without induction of anaesthesia)
Outcomes
Primary Outcomes
Mean arterial pressure
Time Frame: Before induction of anaesthesia to 20 minutes after prone positioning (end of study)
Analysis of change in mean arterial pressure at following time points - before induction of anaesthesia, 2 minutes after anaesthetic induction, 2 minutes after intubation, before turning prone, immediately after turning prone and every 5 minutes thereafter till 20 minutes after positioning.
Secondary Outcomes
- Heart rate(Before induction of anaesthesia to 20 minutes after prone positioning (end of study))
- Cardiac output(Before induction of anaesthesia to 20 minutes after prone positioning (end of study))
- Stroke volume(Before induction of anaesthesia to 20 minutes after prone positioning (end of study))
- Stroke volume variation(Before induction of anaesthesia to 20 minutes after prone positioning (end of study))
- Total peripheral resistance(Before induction of anaesthesia to 20 minutes after prone positioning (end of study))