Using ultrasound to predict predict low blood pressure after giving anaesthesia- a bedside test

Not yet recruiting

• Conditions: Medical and Surgical,

• Registration Number: CTRI/2024/10/075158
• Lead Sponsor: Merlin Shalini Ruth

Brief Summary

Induction of general anesthesia is often associated with hypotension and is a common scenario faced by anesthesiologists. The degree of hypotension can depend on age, comorbidities and anesthetic drugs used during general anesthesia. (1)​

Intraoperative hypotension can have detrimental effects and cause adverse effects such as myocardial infarction, stroke, and acute kidney injury leading to extended hospital stay. (2)​

Therefore, preventing early intraoperative hypotension and maintaining hemodynamic stability can improve patient outcomes. (3)

Patient’s preinduction volume status can have an effect on postinduction hypotension, considering long periods of fasting for elective surgeries. (4)​

Ultrasonography of Inferior Vena Cava diameter (DIVC) and Collapsibility Index of Inferior Vena Cava diameter (DIVC-CI) has been reported to be a useful tool for predicting post-GA hypotension.​

Ultrasound assessment of Inferior vena cava diameter has a few constrains like requirement of curvilinear probe and might have difficulties in visualizing it.​

The subclavian vein (SCV) is located adjacent to the pleura and upstream of the superior vena cava and can be easily visualized in most patients using a linear probe.​

USG Subclavian vein collapsibility index (DSCV-CI) has been shown to be effective in assessing intravascular volume status and intravascular volume measurements during spontaneous breathing as a surrogate partner for DIVC-CI (5).​

Pre-GA-induction ultrasonography of the internal jugular vein area (IJV-A) in the Trendelenburg position was reported to be an independent predictor of hypotension during GA induction and showed venous changes similar to those found in the PLR position (8)​

DSCV-CI was able to predict post GA hypotension in deep inspiration. (6)(7)​

Detailed Description

Not available

Study Timeline

• Study Start: 2024-01-11
• Last Update Posted: 2024-09-10

Recruitment & Eligibility

• Status: Not Yet Recruiting
• Sex: All
• Target Recruitment: 100

Inclusion Criteria

Age 18-70 years ​ Elective surgeries​ ASA : I, II ​ General Anaesthesia ​.

Exclusion Criteria

Patient refusal​ Age : < 18 years​ Emergency surgeries ​ Systolic Blood Pressure > 180 mmHg and < 90 mmHg on day of surgery​ Uncontrolled hypertension ​ Patient with lower limb fracture/dislocation​ Patients with a history of heart failure, moderate or severe valvular heart disease, aortic disease, peripheral arterial disease, left ventricular ejection fraction less than 40% or ASA III or worse will be excluded.​.

Study & Design

• Study Type: Observational
• Study Design: Not specified

Primary Outcome Measures

Name	Time	Method
Determine correlation between pre anaesthesia ultrasound monitoring of subclavian vein diameter changes induced due to spontaneous respiration along with modified passive leg raise to predict the occurrence of hypotension after general anaesthesia in patients posted for elective surgeries	Baseline 10 min post induction of general anaesthesia

Secondary Outcome Measures

Name	Time	Method
To determine if any correlation exists between sex & changes in collapsibility index​	Baseline 10 min post induction of general anaesthesia

Trial Locations

Locations (1)

Chettinad academy of research and education; 🇮🇳 Kancheepuram, TAMIL NADU, India

Chettinad academy of research and education

🇮🇳Kancheepuram, TAMIL NADU, India

V Vinay Krishna

Principal investigator

9962607991

vinaykrishnav@gmail.com