Reliability of ultrasound examination for the prediction of fall in blood pressure under anesthesia in patients undergoing neuro-surgeryâ€

Completed

• Conditions: Neurosurgical patients.

• Registration Number: CTRI/2018/04/013515
• Lead Sponsor: National institute of mental health and neuro sciences

Brief Summary

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.

Detailed Description

Not available

Study Timeline

• Study Start: 2018-05-14
• Study Completion: 2019-07-31
• Last Update Posted: 2020-10-02

Recruitment & Eligibility

• Status: Completed
• Sex: All
• Target Recruitment: 156

Inclusion Criteria

2.ASA status I to III 3.Patients undergoing intracranial neurosurgical procedures.

Exclusion Criteria

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.

Study & Design

• Study Type: Observational
• Study Design: Not specified

Primary Outcome Measures

Name	Time	Method
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.	0,1,3,5,10 MINUTES

Secondary Outcome Measures

Name	Time	Method
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.

Trial Locations

Locations (1)

National institute of mental health and neuro sciences; 🇮🇳 Bangalore, KARNATAKA, India

National institute of mental health and neuro sciences

🇮🇳Bangalore, KARNATAKA, India

Amit goyal

Principal investigator

8800801784

amitgoyal26@ymail.com