Comparison of the Effects of Trendelenburg Position and Passive Leg Lift on Hemodynamics in Abdominal Surgery Patients

Not Applicable

• Conditions: The Angle of Trendelenburg
• Interventions: Other: Trendeleburg -5 degree,-10 degree,-15 degree

• Registration Number: NCT04971122
• Lead Sponsor: The Second Affiliated Hospital of Dalian Medical University

Brief Summary

How to maintain the stability of circulation during anesthesia has always been a concern of clinicians, including shorting the preoperative fasting time under the condition of full preoperative preparation, and giving appropriate amount of nutrient solution in combination with the patient's situation 2\~4 h before surgery to reduce the blood volume insufficiency of patients before general anesthesia induction, vasoactive drugs, etc. Among them, passive leg lifting experiment is widely recognized in the world. Although passive leg lifting has many advantages, it still has some limitations in the operation process. This study tried to find the corresponding head low and foot high Angle corresponding to the same hemodynamic changes caused by passive leg lifting.

Detailed Description

For low head and high feet, studies have shown that 20° can reduce the incidence of hypotension during the induction period of general anesthesia in patients undergoing gastrectomy and has therapeutic effect on it, as well as reduce the use of vasoactive drugs during the induction period of general anesthesia. There were no perioperative complications.

The passive leg lift test can be repeated and does not overload the patient with fluid. However, there is no relevant research on the relationship between the two, which is exactly the innovation of this topic.

Study Timeline

• Study First Submitted: 2021-06-20
• Study First Submitted QC: 2021-07-12
• Study First Posted: 2021-07-21
• Study Start: 2021-09-01
• Status Verified: 2021-10
• Last Update Submitted: 2021-10-15
• Last Update Posted: 2021-10-20
• Primary Completion: 2022-06-30
• Study Completion: 2022-07-15

Recruitment & Eligibility

• Status: UNKNOWN
• Sex: All
• Target Recruitment: 54

Inclusion Criteria

• Age 18~75 years old
• Good image of TTE can be obtained
• Sedative mechanical ventilation （Vt 8～10ml/kg）
• Circulation was relatively stable before the experiment began
• There is no contraindication to rehydration

Exclusion Criteria

• TTE acquisition is not ideal
• Patients did not agree to participate in the experiment
• Diseases of the central nervous system，patients with increased intracranial pressure
• Arrhythmia patients;
• Patients with increased intra-abdominal pressure;
• Bedridden patients;
• Patients with venous thrombosis of lower limbs;
• Patients with venous foreign body of lower limbs;
• Patients with circulatory instability;
• Patients with obstructive shock;
• Patients with moderate or above heart valve reflux

Study & Design

• Study Type: INTERVENTIONAL
• Study Design: SINGLE_GROUP

Arm && Interventions

Group	Intervention	Description
Trendeleburg -5 degree group,-10 degree group,-15 degree group	Trendeleburg -5 degree,-10 degree,-15 degree	Norepinephrine was continuously pumped at 0.5ug/kg/min

Primary Outcome Measures

Name	Time	Method
PPV(pulse pressure variation)	T1:A supine position with a 10° upward bed angulation；T2: After passive leg lift；T3：The same position with T1；T4:After trendelenburg position；T5:The same position with T1;T6:After fluid infusion	Change from PPV at T1to T6
VTI(velocity time integral)	T1:A supine position with a 10° upward bed angulation；T2: After passive leg lift；T3：The same position with T1；T4:After trendelenburg position；T5:The same position with T1;T6:After fluid infusion	Change from VTI at T1 to T6

Secondary Outcome Measures

Name	Time	Method
SBP(Systolic Blood Pressure)	T1:A supine position with a 10° upward bed angulation；T2: After passive leg lift；T3：The same position with T1；T4:After trendelenburg position；T5:The same position with T1;T6:After fluid infusion	The variation tendency of T1 to T6
MAP(Mean Artery Pressure)	T1:A supine position with a 10° upward bed angulation；T2: After passive leg lift；T3：The same position with T1；T4:After trendelenburg position；T5:The same position with T1;T6:After fluid infusion	The variation tendency of T1 to T6
HR HR(Heart Rate)	T1:A supine position with a 10° upward bed angulation；T2: After passive leg lift；T3：The same position with T1；T4:After trendelenburg position；T5:The same position with T1;T6:After fluid infusion	The variation tendency of T1 to T6

Trial Locations

Locations (1)

The Second Affiliated Hospital of Dalian Medical University; 🇨🇳 Dalian, Liaoning, China