Reliability of pre-induction inferior vena cava assessment with ultrasound for the prediction of post-induction hypotension in neurosurgical patients undergoing intracranial surgeryâ€
试验速览
- 阶段
- 不适用
- 状态
- 已完成
- 入组人数
- 156
- 试验地点
- 1
- 主要终点
- To establish a relationship between pre-induction IVC diameter maximum (IVCDmax), Collapsibility index (CI) and post-induction reduction in mean arterial blood pressure (MAP) in neurosurgical patients.
研究概览
简要总结
Hypotensionis one of the most common complications during general anesthesia,specially after induction of general anesthesia. Itsoccurrence is affected by several factors, mainly hypovolemia, old age, ASAstatus 3 and above, anesthetic drugs and dosage, impairedcompensatory mechanisms and impaired cardiac function. Patients withintracranial pathological conditions are more vulnerable to hypovolemia,resulting from poor oral intake (low GCS, lower cranial nerve palsies),vomiting, effect of anti-edema drugs (example- mannitol) and complications likediabetes insipidus,which may lead to post inductionhypotension. The neuroanesthesiologist plays a key role in management ofhypotension, by preemptively diagnosing and correcting the hypovolemic status,and thereby reduce the incidence of post-induction hypotension. However, anassociation between preoperative volume status and the severity ofpost-induction hypotension has not been established in neurosurgical patients.
The aim of this study is to assess the correlation between ultrasonographic measurementof inferior vena cava diameter and post-induction hypotension during generalanesthesiain neurosurgical patients.
研究设计
- 研究类型
- Observational
入排标准
- 年龄范围
- 18.00 Year(s) 至 65.00 Year(s)（—）
- 性别
- All
入选标准
- •2.ASA status I to III 3.Patients undergoing intracranial neurosurgical procedures.
排除标准
- •1.Age group below 18 and above 65 years 2.ASA status IV and above 3.Patients with traumatic brain injury 4.Patients on mechanical ventilation and/ not having spontaneous breathing 5.Multiple intubation attempt or prolonged intubation time 6.Difficult airway 7.Baseline mean blood pressure (MAP) <65mmHg 8.Repeat surgery within a week 9.Patient with significant cardiac impairment 10.Skin infection at the site of examination 11.History of recent upper abdominal surgery 12.Autonomic nervous disorders 13.Prior use of angiotensin-converting enzyme inhibitor or angiotensin receptor blocker.
结局指标
主要结局
To establish a relationship between pre-induction IVC diameter maximum (IVCDmax), Collapsibility index (CI) and post-induction reduction in mean arterial blood pressure (MAP) in neurosurgical patients.
时间窗: 0,1,3,5,10 MINUTES
次要结局
- 1.To observe the duration and severity of reduction in mean arterial blood pressure following induction of anesthesia, in relation to the IVCDmax and CI.(2.To calculate the total dose of mephentermine required to correct hypotension following induction of anesthesia, in relation to the IVCDmax and CI.)