Clinical trial NCT02002494: Jugular Venous Flow Healthy Volunteers
Official title: Effect of Different Surgical Positions on the Cerebral Venous Drainage: an Ultrasound Study on Healthy Volunteers
Study type: OBSERVATIONAL
Overall status: COMPLETED
Conditions: Jugular Venous Blood Flow
Lead sponsor: University Health Network, Toronto
Sponsor class: OTHER
First posted: 2013-12-05
Enrollment: 27
Sex: ALL
Minimum age (years): 18
Standard ages: ADULT
OLDER_ADULT
Accepts healthy volunteers: yes
Observational model: COHORT
Time perspective: PROSPECTIVE
Sampling method: NON_PROBABILITY_SAMPLE
Study population: Healthy Volunteers

Brief summary: Our hypothesis is that there will be a decrease in internal jugular venous flow in the park bench position when compared to the supine position. There will also be a change in blood flow in the between right and left internal jugular veins in park bench position, particularly there will be a greater reduction of flow on the dependent side. However, the internal jugular venous flow will be the same in both the prone and supine position.

Detailed description: The different positions used in neurosurgery (park bench, prone) for better accessibility to the operating field can impact on the cerebral venous drainage due to the effects of internal jugular venous outflow of blood and may increase intracranial pressure. The kinking of the internal jugular vein due to excessive neck flexion and rotation in park bench or flexion in the prone position may lead to kinking or twisting of the vein. This has been hypothesized as the major cause of disturbed venous drainage during surgery and in postoperative patients may lead to neck swelling, brachial plexus injury, macroglossia (swollen tongue), delayed airway obstruction and increases in intracranial pressure.

Optimal brain perfusion is best in the neutral position of the head, but surgery cannot always be performed with this. Thus, we look to measure the internal jugular venous flow at different positions as there have been little studies looking at this important contributing factor.

Eligibility criteria: Inclusion Criteria:

* Adult healthy volunteers who are above the age of 18
* American Society of Anesthesiologists classification (ASA) 1
* Body mass index (BMI) less than and equal to 35

Exclusion Criteria:

* ASA 2 and above
* BMI above 35
* Lack of informed consent
* Language barrier
* Medical students and anaesthesia residents going through the department as part of their rotation

Primary outcomes:
measure: Internal Jugular Venous (IJV) Cross Sectional Area
timeFrame: 1 day
measure: Right and Left IJV Cross Sectional Area
timeFrame: 1 day
measure: Internal Jugular Venous (IJV) Doppler Velocity
timeFrame: 1 day
measure: Bilateral Internal Jugular Vein (IJV) Flow
timeFrame: 1 day
measure: Bilateral Internal Jugular Vein (IJV) Doppler Velocity
timeFrame: 1 day
measure: R IJV and L IJV Flow
timeFrame: 1 day
Secondary outcomes:
Other outcomes:
Locations:
city: Toronto
country: Canada
facility: University Health Network, Toronto Western Hospital
state: Ontario
Study officials:
affiliation: University Health Network, Toronto Western Hospital
name: Lashmi Venkatraghavan
role: PRINCIPAL_INVESTIGATOR
affiliation: University Health Network, Toronto Western Hospital
name: Vincent Chan
role: PRINCIPAL_INVESTIGATOR
affiliation: University Health Network, Toronto Western Hospital
name: Pirjo Manninen
role: PRINCIPAL_INVESTIGATOR
affiliation: University Health Network, Toronto Western Hospital
name: Audrey MY Tan
role: PRINCIPAL_INVESTIGATOR
References: