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Jugular Venous Flow Neurosurgical Patients

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ClinicalTrials.gov Identifier: NCT02002507
Recruitment Status : Withdrawn (We faced technical problem before conducting this study)
First Posted : December 5, 2013
Last Update Posted : May 14, 2020
Sponsor:
Information provided by (Responsible Party):
Lashmi Venkatraghavan, University Health Network, Toronto

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 between the right and left internal jugular veins in the park bench position. In particular, 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 positions.

Condition or disease Intervention/treatment
Jugular Venous Flow Other: comparison of different neurosurgical position

Detailed Description:
The different positions used in neurosurgery for better accessibility to the operating field (park bench, prone) can impact cerebral venous drainage due to the effects of internal jugular venous outflow of blood, and may increase intracranial pressure. Excessive neck flexion and rotation in the park bench position, or flexion in the prone position, may lead to kinking or twisting of the internal jugular vein. This has been hypothesized as the major cause of disturbed venous drainage during surgery and may lead to neck swelling, brachial plexus injury, macroglossia (swollen tongue), delayed airway obstruction, and increases in intracranial pressure in postoperative patients. Optimal brain perfusion is best in the neutral position of the head, but surgery cannot always be performed in this position. Thus, we look to measure the internal jugular venous flow at different positions, as there have been few studies looking at this important contributing factor.

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Study Type : Observational
Actual Enrollment : 0 participants
Observational Model: Cohort
Time Perspective: Prospective
Official Title: Effect of Different Surgical Positions on the Cerebral Venous Drainage: an Ultrasound Study on Neurosurgical Patients
Actual Study Start Date : January 2015
Estimated Primary Completion Date : November 21, 2019
Estimated Study Completion Date : December 31, 2019

Group/Cohort Intervention/treatment
park bench position
Comparing jugular venous flow in supine and park bench position in neurosurgical patients requiring their surgery in park bench position
Other: comparison of different neurosurgical position
in 2 of 3 positions (supine, plus either prone or park bench) with both left and right internal jugular vein cross-sectional area of vein, doppler velocity, internal jugular venous flow, position of internal jugular vein in relation to carotid artery (All measured with the use of ultrasound)

prone position
Comparing the jugular venous flow in the supine and prone position in patients requiring their surgery to be done in the prone position.
Other: comparison of different neurosurgical position
in 2 of 3 positions (supine, plus either prone or park bench) with both left and right internal jugular vein cross-sectional area of vein, doppler velocity, internal jugular venous flow, position of internal jugular vein in relation to carotid artery (All measured with the use of ultrasound)




Primary Outcome Measures :
  1. Jugular venous flow [ Time Frame: 1 day ]

    One of the following will be compared depending on the position of the patient

    • Bilateral internal jugular venous flow in supine and prone position
    • Bilateral internal jugular venous flow in supine and park bench position


Secondary Outcome Measures :
  1. cross- sectional area of internal jugular vein [ Time Frame: 1 day ]
    Comparing the cross-sectional area of the internal jugular vein in different positions

  2. doppler velocity of jugular venous flow [ Time Frame: 1 day ]
    Comparing the doppler velocity of jugular venous flow in different surgical positions in neurosurgical patients



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Ages Eligible for Study:   18 Years and older   (Adult, Older Adult)
Sexes Eligible for Study:   All
Accepts Healthy Volunteers:   No
Sampling Method:   Non-Probability Sample
Study Population
Neurosurgical patients in either park bench or prone position for their surgery
Criteria

Inclusion Criteria:

  • Adult neurosurgical patients who are above the age of 18
  • Patients undergoing neurosurgery requiring general anesthesia and placement in either in prone or park bench position for surgical accessibility

Exclusion Criteria:

  • Lack of informed consent
  • Patients undergoing surgical procedures only in the supine position
  • Patients needing a central venous catheter in the neck

Information from the National Library of Medicine

To learn more about this study, you or your doctor may contact the study research staff using the contact information provided by the sponsor.

Please refer to this study by its ClinicalTrials.gov identifier (NCT number): NCT02002507


Locations
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Canada, Ontario
University Health Network, Toronto Western Hospital
Toronto, Ontario, Canada, M5T 2S8
Sponsors and Collaborators
University Health Network, Toronto
Investigators
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Principal Investigator: Lashmi Venkatraghavan University Health Network, Toronto Western Hospital
Principal Investigator: Vincent Chan University Health Network, Toronto Western Hospital
Principal Investigator: Pirjo Manninen University Health Network, Toronto Western Hospital
Principal Investigator: Audrey MY Tan University Health Network, Toronto Western Hospital
Principal Investigator: Jigesh Mehta University Health Network, Toronto Western Hospital
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Responsible Party: Lashmi Venkatraghavan, Dr., University Health Network, Toronto
ClinicalTrials.gov Identifier: NCT02002507    
Other Study ID Numbers: 13-6432-BE
First Posted: December 5, 2013    Key Record Dates
Last Update Posted: May 14, 2020
Last Verified: May 2020