Jugular Venous Flow Neurosurgical Patients

Withdrawn

• Conditions: Jugular Venous Flow
• Interventions: Other: comparison of different neurosurgical position

• Registration Number: NCT02002507
• Lead Sponsor: University Health Network, Toronto

Brief Summary

Our hypothesis is that there will be a decrease in internal jugular venous flow in the park bench position when compared to the supine position. There will also be a change in blood flow between the right and left internal jugular veins in the park bench position. In particular, there will be a greater reduction of flow on the dependent side. However, the internal jugular venous flow will be the same in both the prone and supine positions.

Detailed Description

The different positions used in neurosurgery for better accessibility to the operating field (park bench, prone) can impact cerebral venous drainage due to the effects of internal jugular venous outflow of blood, and may increase intracranial pressure. Excessive neck flexion and rotation in the park bench position, or flexion in the prone position, may lead to kinking or twisting of the internal jugular vein. This has been hypothesized as the major cause of disturbed venous drainage during surgery and may lead to neck swelling, brachial plexus injury, macroglossia (swollen tongue), delayed airway obstruction, and increases in intracranial pressure in postoperative patients. Optimal brain perfusion is best in the neutral position of the head, but surgery cannot always be performed in this position. Thus, we look to measure the internal jugular venous flow at different positions, as there have been few studies looking at this important contributing factor.

Study Timeline

• Study First Submitted: 2013-11-29
• Study First Submitted QC: 2013-12-04
• Study First Posted: 2013-12-05
• Study Start: 2015-01
• Primary Completion: 2019-11-21
• Study Completion: 2019-12-31
• Status Verified: 2022-12
• Last Update Submitted: 2022-12-20
• Last Update Posted: 2022-12-22

Recruitment & Eligibility

• Status: WITHDRAWN
• Sex: All
• Target Recruitment: Not specified

Inclusion Criteria

• Adult neurosurgical patients who are above the age of 18
• Patients undergoing neurosurgery requiring general anesthesia and placement in either in prone or park bench position for surgical accessibility

Exclusion Criteria

• Lack of informed consent
• Patients undergoing surgical procedures only in the supine position
• Patients needing a central venous catheter in the neck

Study & Design

• Study Type: OBSERVATIONAL
• Study Design: Not specified

Arm && Interventions

Group	Intervention	Description
park bench position	comparison of different neurosurgical position	Comparing jugular venous flow in supine and park bench position in neurosurgical patients requiring their surgery in park bench position
prone position	comparison of different neurosurgical position	Comparing the jugular venous flow in the supine and prone position in patients requiring their surgery to be done in the prone position.

Primary Outcome Measures

Name	Time	Method
Jugular venous flow	1 day	One of the following will be compared depending on the position of the patient; * Bilateral internal jugular venous flow in supine and prone position; * Bilateral internal jugular venous flow in supine and park bench position

Secondary Outcome Measures

Name	Time	Method
cross- sectional area of internal jugular vein	1 day	Comparing the cross-sectional area of the internal jugular vein in different positions
doppler velocity of jugular venous flow	1 day	Comparing the doppler velocity of jugular venous flow in different surgical positions in neurosurgical patients

Trial Locations

Locations (1)

University Health Network, Toronto Western Hospital; 🇨🇦 Toronto, Ontario, Canada