Echocardiography Examination Of The Cardiac Effects Of Different Regional Anesthesia Methods

Study Overview
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Brief Summary
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Nerve blocks applied with neuraxial anesthesia and ultrasonography are used for many operations today. Neuraxial blocks cause varying degrees of decrease in the blood pressure level of the patients. Peripheral blocks may be preferred to avoid the cardiac effects of the neuraxial anesthesia method.

Detailed Description
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The hypothesis of this study was that spinal anesthesia applied in intertrochanteric femoral fracture operations caused hypotension by lowering the cardiac ejection fraction. In our study, The investigators aimed to find out the effect of different regional anesthesia methods on the cardiac function of the patients by echocardiography.

Official Title
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Echocardiographic Investigation of the Cardiac Effects of Different Regional Anesthesia Methods Used in Intertrochanteric Femoral Fracture Operations

Conditions
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Femur Fracture, Spinal Anesthesia, Lumbar Plexus Block

Intervention / Treatment
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* Device: Transthoracic echocardiogram


Participation Criteria
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Eligibility Criteria
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Inclusion Criteria: 60-100 years old American Society of Anesthesiologist Score I-IV Exclusion Criteria: Local anesthetic allergy Bleeding disorder Mental disorder Allergy to drugs used Body mass index above 30

Ages Eligible for Study
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Minimum Age: 60 Years
Maximum Age: 100 Years

Sexes Eligible for Study
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All

Accepts Healthy Volunteers
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No

Study Plan
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How is the study designed?
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Design Details

Primary Purpose: Diagnostic
Allocation: Non-Randomized
Intervention Model: Parallel Assignment
Masking: None (Open Label)


Arms and Interventions

| Participant Group/Arm | Intervention/Treatment |
| --- | --- |
| Active Comparator: spinal anesthesia<br> | Device: Transthoracic echocardiogram<br>* Transthoracic echocardiogram will be performed before the operation and at certain time intervals during the operation.<br>|
| Active Comparator: lumbar plexus+sacral plexus block<br> | Device: Transthoracic echocardiogram<br>* Transthoracic echocardiogram will be performed before the operation and at certain time intervals during the operation.<br>|

What is the study measuring?
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Primary Outcome Measures

| Outcome Measure | Measure Description | Time Frame |
| --- | --- | --- |
| Ejection fraction | Ejection fraction (EF) measurement will be made with Simpson's method and fractional shortening method. | peroperative | 

Secondary Outcome Measures

| Outcome Measure | Measure Description | Time Frame |
| --- | --- | --- |
| intraoperative blood pressure monitoring | systolic, diastolic and median blood pressure values | peroperative | 
| cardiac diastolic dysfunction | The echocardiogram will measure the flow velocity between the left atrium and ventricle in cm/s in pulsed wave mode and the E/A ratio will be calculated. | peroperative | 
| Entropy | Depth of anesthesia will be measured by placing Entropy sensors on the forehead as needed. | peroperative | 
| sedative drug | The drugs used for sedation and their amounts will be recorded. | intraoperative | 
| ramsey sedation scale | point Awake, restless and/or crying. points Alert, calm, watching his surroundings. points Sleepy but responds to verbal stimuli points Sleepy but immediately responds to glabellar tactile stimuli. points Sleepy but responds slowly to glabellar tactile stimuli. points Does not respond to Alerts. | intraoperative |