Ability of Carotid Sonography and Inferior Vena Cava Sonography for the Prediction of Post-induction Hypotension in Hypertensive Patients

NCT ID: NCT03986112

Last Updated: 2019-06-17

Basic Information

• Recruitment Status: UNKNOWN
• Total Enrollment: 58 participants
• Study Classification: OBSERVATIONAL
• Study Start Date: 2019-07-31
• Study Completion Date: 2020-05-31

Brief Summary

Hypertensive patients have more hemodynamic instability during general anesthesia than do patients with NORMOTENSION. In this study, the investigators evaluated the usefulness of carotid ultrasound and inferior vena cervical ultrasound for predicting hypotension after induction of anesthesia in patients with hypertension.

Detailed Description

Carotid and venous ultrasonography is performed in a comfortable state. Corrected blood flow after carotid ultrasound and carotid artery blood flow rate were measured.

After inferior vena cava sonography, using the embedded software, the collapsibility Index by measuring the largest and smallest diameter during the respiratory cycle will be obtained.

After confirming baseline blood pressure and pulse rate, propofol 2 mg / kg is administered and remifentanil is maintained at 4.0 ng / mL using the Target Control System (TCI).

Following the administration of rocuronium 1.0-1.2 mg / kg, and 1 minute and 30 seconds after BIS 60 or less, endotracheal intubation is performed using video laryngoscope.

Blood pressure and heart rate are measured at prior to induction, 1 minute after the induction, immediately after intubation, and at 1, 3, 5, 7 and 10 minutes after intubation.

Post-induction hypotension after anesthesia induction is considered as a decrease of 20% or more of the pre-anesthesia blood pressure or a mean arterial blood pressure of less than 60 mmHg.

In the event of hypotension in accordance with the above definition, repeated administration of ephedrine 4 mg or phenylephrine 50 mcg is used.

Conditions

General Anesthesia

Study Design

• Observational Model Type: CASE_ONLY
• Study Time Perspective: PROSPECTIVE

Study Groups

hypertensive group

Evaluation of the ability of carotid sonography and inferior vena cava sonography for the post-induction hypotension in hypertensive patients undergoing general anesthesia

carotid sonography and inferior vena cava sonography

Intervention Type: BIOLOGICAL

Carotid and venous ultrasonography is performed in a comfortable state. Corrected blood flow after carotid ultrasound and carotid artery blood flow rate were measured. After inferior vena cava sonography, the collapsibility Index by measuring the largest and smallest diameter during the respiratory cycle will be obtained. Propofol 2 mg / kg is administered and remifentanil is maintained at 4.0 ng / mL using the Target Control System. Blood pressure and heart rate are measured at prior to induction, 1 minute after induction, immediately after intubation, and at 1, 3, 5, 7 and 10 minutes after intubation. Post-induction hypotension is considered as a decrease of 20% or more of baseline blood pressure or a mean arterial blood pressure of less than 60 mmHg. In the event of hypotension in accordance with the above definition, repeated administration of ephedrine 4 mg or phenylephrine 50 mcg is used.

Interventions

carotid sonography and inferior vena cava sonography

Carotid and venous ultrasonography is performed in a comfortable state. Corrected blood flow after carotid ultrasound and carotid artery blood flow rate were measured. After inferior vena cava sonography, the collapsibility Index by measuring the largest and smallest diameter during the respiratory cycle will be obtained. Propofol 2 mg / kg is administered and remifentanil is maintained at 4.0 ng / mL using the Target Control System. Blood pressure and heart rate are measured at prior to induction, 1 minute after induction, immediately after intubation, and at 1, 3, 5, 7 and 10 minutes after intubation. Post-induction hypotension is considered as a decrease of 20% or more of baseline blood pressure or a mean arterial blood pressure of less than 60 mmHg. In the event of hypotension in accordance with the above definition, repeated administration of ephedrine 4 mg or phenylephrine 50 mcg is used.

Intervention Type: BIOLOGICAL

Eligibility Criteria

Inclusion Criteria

• 1) 19-80 years old hypertensive patients with ASA class I-III
• 2) Scheduled surgery under general anesthesia

Exclusion Criteria

• 1) Emergency operation
• 2) Reoperation
• 3) Patients with history of heart failure (unstable angina, congestive heart failure, coronary artery disease)
• 4) Patients under 40 % of Ejection faction
• 5) Patients with history of valvular heart failure
• 6) Patients with history of peripheral arterial occlusive disease
• 7) Patients with history of arrhythmia (specially AV nodal block), ventricular conduction problem
• 8) Pregnancy patients
• 9) Patients who cannot read the consent form (examples: Illiterate, foreigner)
• 10) Patients with history of uncontrolled psychiatric disease (PTSD, anxiety, depression)
• 11) Patients who withdraw the consent

• Minimum Eligible Age: 19 Years
• Maximum Eligible Age: 80 Years
• Eligible Sex: ALL
• Accepts Healthy Volunteers: No

Sponsors

Yonsei University

OTHER

Sponsor Role: lead

Responsible Party

Responsibility Role: SPONSOR

Locations

Department of Anesthesiology and Pain Medicine, Anesthesia and Pain Research Institue, Yonsei Universiy College of Medicine

Seoul, , South Korea

Countries

South Korea

Central Contacts

So yeon Kim, MD

Role: CONTACT

knnyyy@yuhs.ac

+82-10-8871-2786

Facility Contacts

So Yeon Kim, MD

Role: primary

knnyyy@yuhs.ac

82-10-8871-2786

Other Identifiers

1-2018-0064

Identifier Type: -

Identifier Source: org_study_id