Stroke Volume Variation and Plethysmography Variability Index as Goal Directed Fluid Therapy in Major Oncosurgeries
Condition: Goal Directed Fluid Therapy
MeSH terms: Stroke
Study type: Interventional

Summary: 
      Patients were allotted to two Groups , SVV Guided Fluid Therapy Group received intraoperative
      fluids to maintain SVV <11 , and PVI Guided Group received intraoperative Fluids to maintain
      PVI<11
    

Detailed description: 
      Preinduction Epidural catheter will be placed and Standard General Anaesthesia with Volume
      Controlled Ventilation (Tidal Volume 8ml/Kilogram ) and Positive End Expiratory Pressure 5
      centimeters of water for all patients. Postinduction Radial artery cannulation and Ultrasound
      guided Internal Jugular cannulation will be performed for all patients .Maintenance Fluid
      crystalloids 2ml/kg will be given to both the Groups. In Stroke Volume Variation SVV Group
      Flotrac Transducer (MHD8 model Edwards Lifesciences LLC, Irvine,CA 92614,USA) will be
      attached to radial artery cannula to obtain SVV values and for values < 11 colloid bolus
      200ml will be given over 10 minutes and postbolus values noted. In Plethysmography
      Variability Index PVI Group pulse Oximeter will be placed on index finger and covered to
      avoid ambient light will be attached to Masimo Radical 97 Monitor to measure continuous
      Perfusion Index and Plethysmography Variability Index for values <11 colloid bolus 200ml will
      be given over 10 minutes and change in PVI value noted. Intraoperative heart rate , Mean
      arterial Pressure , Oxygen Saturation, End tidal carbon dioxide, Central venous pressure ,
      Urine output will be measured in all patients.With optimal fluids if Mean Arterial Pressure
      is below 70 mmHg than titrating dosage Norepinephrine infusion will be commenced.At the end
      of surgery reversal agents will be administered and trachea extubated , note will be made of
      any patient requiring postoperative ventilator support.Arterial blood gas analysis will be
      performed at beginning and end of surgery and at postoperative 24 and 48 hours to measure
      serum lactate levels . Patient will be monitored in Postanaesthesia Care Unit for any Cardiac
      , Respiratory event , Serum Creatinine levels will be measures at 24 and 48 hours ,
      Appearance of bowel sounds will be noted , Length of ICU stay will be recorded for all
      patients.
    

Intervention name(s): Intraoperative SVV Guided Fluid Therapy; Intraoperative PVI Guided Fluid Therapy
Intervention type(s): Other; Other
Intervention description(s): Patients will receive intraoperative maintenance Fluids as crystalloids to maintain SVV <11%, for values >11%colloid bolus 6%hydroxyethyl starch will be given and fluid responsiveness noted.; Patients will receive intraoperative maintenance Fluids as crystalloids to maintain PVI <10%, for values >10%colloid bolus 6%hydroxyethyl starch will be given and fluid responsiveness noted.
Allocation: Randomized
Intervention model: Parallel Assignment
Intervention model description: Patients were allotted to either SVV Guided or PVI Guided Intraoperative Fluid Therapy
Masking: Single (Participant)
Primary purpose: Other
Keywords: Goal directed Fluid Therapy; Stroke Volume Variation; Plethysmography