Clinical trial NCT03986112: Ability of Carotid Sonography and Inferior Vena Cava Sonography for the Prediction of Post-induction Hypotension in Hypertensive Patients
Official title: Ability of Carotid Sonography and Inferior Vena Cava Sonography for the Prediction of Post-induction Hypotension in Hypertensive Patients
Study type: OBSERVATIONAL
Overall status: UNKNOWN
Conditions: General Anesthesia
Keywords: carotid sonography
inferior vena cava sonography
hypertension
general anesthesia
predictive power
Lead sponsor: Yonsei University
Sponsor class: OTHER
First posted: 2019-06-14
Enrollment: 58
Sex: ALL
Minimum age (years): 19
Maximum age (years): 80
Standard ages: ADULT
OLDER_ADULT
Accepts healthy volunteers: no
Observational model: CASE_ONLY
Time perspective: PROSPECTIVE
Sampling method: NON_PROBABILITY_SAMPLE
Study population: Hypertensive patients aged 19 to 80 years who are scheduled to undergo surgery under general anesthesia

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.

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

Primary outcomes:
measure: Prediction power of the post-induction hypotension of carotid sonography and inferior vena cava sonography
timeFrame: Prior to induction
measure: Prediction power of the post-induction hypotension of carotid sonography and inferior vena cava sonography
timeFrame: 1 minute after anesthetic induction
measure: Prediction power of the post-induction hypotension of carotid sonography and inferior vena cava sonography
timeFrame: Immediately after intubation
measure: Prediction power of the post-induction hypotension of carotid sonography and inferior vena cava sonography
timeFrame: 1 minute after tracheal intubation
measure: Prediction power of the post-induction hypotension of carotid sonography and inferior vena cava sonography
timeFrame: 3 minutes after tracheal intubation
measure: Prediction power of the post-induction hypotension of carotid sonography and inferior vena cava sonography
timeFrame: 5 minutes after tracheal intubation
measure: Prediction power of the post-induction hypotension of carotid sonography and inferior vena cava sonography
timeFrame: 7 minutes after tracheal intubation
measure: Prediction power of the post-induction hypotension of carotid sonography and inferior vena cava sonography
timeFrame: 10 minutes after tracheal intubation
Secondary outcomes:
Other outcomes:
Locations:
city: Seoul
country: Korea, Republic of
facility: Department of Anesthesiology and Pain Medicine, Anesthesia and Pain Research Institue, Yonsei Universiy College of Medicine
Study officials:
References: