Preanaesthesia ultrsound 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- Prospective observational study.
试验速览
- 阶段
- 不适用
- 状态
- 尚未招募
- 发起方
- 入组人数
- 100
- 试验地点
- 1
- 主要终点
- 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
研究概览
简要总结
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)​
研究设计
- 研究类型
- Observational
入排标准
- 年龄范围
- 18.00 Year(s) 至 70.00 Year(s)（—）
- 性别
- All
入选标准
- •Age 18-70 years ​ Elective surgeries​ ASA : I, II ​ General Anaesthesia ​.
排除标准
- •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.​.
结局指标
主要结局
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
时间窗: Baseline 10 min post induction of general anaesthesia
次要结局
- To determine if any correlation exists between sex & changes in collapsibility index​(Baseline 10 min post induction of general anaesthesia)