Tricuapid Annular Plane Sistolic Excursion Before General Anesthesia Can Predict Hypotension After Induction

Study Overview
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Brief Summary
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the investigators purpose is to predict hypotensive condition that can develop after general anesthesia induction by measuring the Tricuspid Annular Plane Systolic Movement (TAPSE), which is an echocardiographic parameter.

Detailed Description
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Intraoperative hypotension development might increase myocardial damage, acute kidney damage, and septic complications, and have an effect on mortality increase. For this reason, prevention of an unwanted hypotensive event has an important role in reducing mortality and morbidity. The prediction of the risk of hypotension is generally based on the evaluation of the comorbid status and volume status of patients .It is already known that right ventricular systolic dysfunction has prognostic value in various pathological cases. It is quite difficult to evaluate the RV function with echocardiography because of the complex geometry of RV. Although RV function has been evaluated only visually for many years, guidelines have been published as a result of recent studies by the American Society of Echocardiography. In this respect, abnormal RV function should be suspected when one of the criteria of S '<10 cm /s, TAPSE <16 mm, RVFAC <35%, or R-MPI (Tissue Doppler)> 0.55. Normal and abnormal function is distinguished more reliably when combining more than one RV function measures. TAPSE is a parameter with which the apex-basal shortening can be easily measured, providing specific data on global RV function. It depends less on optimal image quality than other RV function measurements, and is an easy-to-measure criterion. Low TAPSE is not very common; however, it was measured in people with no heart disease due to diagnostic misclassification and excessive ends of the normal spectrum. the investigators think that despite the lack of cardiac disease, cardiac reserve functions of each patient may have limits in terms of development of hypotension in general anesthesia induction. The investigators considered that TAPSE, which decreased within normal limits in patients without cardiac disease, could predict hypotension development in general anesthesia induction, and planned study for this purpose.

Official Title
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Tricuapid Annular Plane Sistolic Excursion Before General Anesthesia Can Predict Hypotension After Induction

Conditions
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Anesthesia

Participation Criteria
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Eligibility Criteria
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Inclusion Criteria: Patients scheduled for elective surgery Patients who will receive general anesthesia Patients between 18-65 years of age Physical status I or II according to the American Society of Anesthetists (ASA) in preoperative evaluation Those without known heart disease Patients with TAPSE value above 1.6 cm Exclusion Criteria: Patients under the age of 8 and over 65, Pregnant patients, Patients who refuse to participate in the study, ASA III and above, Patients with known heart disease, Patients with TAPSE value of less than 1.6 measured with Transthoracic Echocardiography will not be allowed to be included in the study. Patients with difficult airway management or difficult intubation will be excluded from the study.

Ages Eligible for Study
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Minimum Age: 18 Years
Maximum Age: 65 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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Arms and Interventions

| Participant Group/Arm | Intervention/Treatment |
| --- | --- |
| hypotension<br>Basal hemodynamic parameters and hemodynamic values will be taken every two minutes after induction until surgical incision. Patients with systolic pressure <90 mmHg or 30% drop in baseline, and mean artery pressure below 60 mmHg will be considered to have hypotension. Patients will be divided into two groups as Hypotension and No Hypotension. | |
| no hypotension<br>Basal hemodynamic parameters and hemodynamic values will be taken every two minutes after induction until surgical incision. Patients with systolic pressure <90 mmHg or 30% drop in baseline, and mean artery pressure below 60 mmHg will be considered to have hypotension. Patients will be divided into two groups as Hypotension and No Hypotension. | |

What is the study measuring?
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Primary Outcome Measures

| Outcome Measure | Measure Description | Time Frame |
| --- | --- | --- |
| tricuspid anular plane systolic excursion(TAPSE) | The investigators purpose is to predict hypotensive condition that can develop after general anesthesia induction by measuring the Tricuspid Annular Plane Systolic Movement (TAPSE), which is an echocardiographic parameter. | TAPSE will be measured with Transthoracic Echocardiography about 30 minutes before the induction in the preoperative period. | 

 Terms related to the study
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Keywords Provided by Centre Hospitalier Valida
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General anesthesia, tricuspid anular plane systolic excursion, hypotension