Cardiac Output and Other Hemodynamic Changes With Prone Position in Cervical Myelopathy Patients Undergoing Surgery
试验速览
- 阶段
- 不适用
- 状态
- 已完成
- 发起方
- 入组人数
- 30
- 主要终点
- Mean arterial pressure
研究概览
简要总结
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)
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
- 18 Years 至 65 Years（Adult, Older Adult）
- 性别
- All
- 接受健康志愿者
- 否
入选标准
- •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
排除标准
- •Atlanto occipital dislocation and cervicomedullary junction pathology
- •Tumour pathology
- •Diabetic patients
- •Patients positioned prone in the awake state (without induction of anaesthesia)
结局指标
主要结局
Mean arterial pressure
时间窗: 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.
次要结局
- 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))
研究者
Dhritiman Chakrabarti
Assistant Professor of Neuroanaesthesiology
National Institute of Mental Health and Neuro Sciences, India