Hemodynamic Effects of Continuous Spinal Anesthesia in Patient Aged Over 65 Years
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|ClinicalTrials.gov Identifier: NCT03195166|
Recruitment Status : Recruiting
First Posted : June 22, 2017
Last Update Posted : October 16, 2018
Compared to single-dose spinal anesthesia, continuous spinal anesthesia using small titrated doses of local anesthetic, was safe, efficient and provided better hemodynamic profile in elderly patients.
The aim of this study was to investigate the hemodynamic effects of continuous spinal anesthesia in elderly patients undergoing knee arthroplasty.
Investigators use the FloTrac sensor/Vigileo haemodynamic monitoring system to assess modification blood pressure, stroke volume and cardiac output during anesthesia and specialy after every bolus of spinal anesthesia, after inflating the tourniquet and after putting it off.
they recorded number of hypotension episodes, ephedrine bolus and consumption until 2 hours after the end of surgery.
|Condition or disease||Intervention/treatment||Phase|
|Hemodynamic Instability||Diagnostic Test: FloTrac sensor/Vigileo||Not Applicable|
The aim of this study was to investigate the hemodynamic effects of continuous spinal anesthesia (CSA) in elderly patients undergoing knee arthroplasty.
Adult patients, aged more than 65 years scheduled for elective total knee arthroplasty under regional anesthesia.
Study Design :
Patients had a transthoracic echocardiography one to three months before the surgical procedure, performed by a cardiologist.
An oral intake of 250 ml of water was taken 2 hours before surgery. In the operating room, patients received monitoring with electrocardiogram, pulse oximetry and had their blood pressure measured and recorded via an indwelling radial arterial catheter putting under local anesthesia.
This catheter was connected to the FloTrac sensor/Vigileo haemodynamic monitoring systeme to track continuously stroke volume and cardiac output.
All patients were given nasal oxygen during all the procedure to keep oxygen saturation > 95 %. Fluid therapy was limited to 4 ml/kg/h until tourniquet release.
Subarachnoid puncture was performed with a 19-Gauge Tuohy needle at the L3-S1 interspace using a midline approach. Three cm of a 22-Gauge catheter was introduced through the needle. An initial dose of 2,5 mg isobaric 0,5% bupivacaine was injected through the catheter. Additional 2,5 mg isobaric 0,5% bupivacaine doses were injected every 10 minutes until sensory blockade reached T10.
Ephedrine 6 to 9 mg was given if systolic arterial pressure < 90 mmHg or < 100 mmHg with clinical signs of poor tolerance (dizziness, anxiety, dyspnea, vomiting).
Sample size We included 20 patients in this observational study.
|Study Type :||Interventional (Clinical Trial)|
|Estimated Enrollment :||20 participants|
|Intervention Model:||Single Group Assignment|
|Intervention Model Description:||
The aim of this study was to investigate the hemodynamic effects of continuous spinal anesthesia in elderly patients. An oral intake of 250 ml of water was taken 2 hours before surgery.
Radial arterial catheter was putted under local anesthesia and connected to the FloTrac sensor/Vigileo haemodynamic monitoring system.
Fluid therapy was limited to 4 ml/kg/h until tourniquet release.
Subarachnoid puncture was performed at the L3-S1 interspace. An initial dose of 2,5 mg isobaric 0,5% bupivacaine was injected. Additional 2,5 mg isobaric 0,5% bupivacaine doses were injected every 10 minutes until sensory blockade reached T10.
Ephedrine 6 to 9 mg was given if systolic arterial pressure < 90 mmHg. Investigators measured blood pressure (systolic, diastolic and mean), stroke volume and cardiac output every 5 minutes from beginning of the operation and until 2 hours after the end.
Number of hypotension episodes and ephedrine consumption were noted.
|Masking:||None (Open Label)|
|Masking Description:||consecutive patient|
|Official Title:||Hemodynamic Effects of Continuous Spinal Anesthesia in Patient Aged Over 65 Years Undergoing Total Knee Arthroplasty|
|Actual Study Start Date :||October 3, 2017|
|Estimated Primary Completion Date :||December 31, 2018|
|Estimated Study Completion Date :||March 31, 2019|
Experimental: hemodynamic profile
Diagnostic Test: FloTrac sensor/Vigileo
blood pressure (systolic, diastolic and mean), stroke volume cardiac output ephedrine consumption after bupivacaine continuous spinal anesthesia
- hemodynamic profile during continuous spinal anesthesia in elderly [ Time Frame: Day 0 ]cardiac output , L/min
- blood pressure variation [ Time Frame: Day 0 ]systolic blood pressure, diastolic blood pressure, mean blood pressure, mmHg
- ephedrine use [ Time Frame: Day 0 ]ephedrine consumption , mg
- stoke volume modification [ Time Frame: Day 0 ]stroke volume, L
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): NCT03195166
|Contact: SESSI KAISER, MDemail@example.com|
|Contact: BARGAOUI ABERAHMEN, MDfirstname.lastname@example.org|
|Kassab orthopedic Institute||Recruiting|
|Tunis, La Manouba, Tunisia, 2010|
|Contact: Sessi kaiser, MD +21053688132 email@example.com|
|Contact: BARGAOUI ABERAHMEN, MD +21622849078 firstname.lastname@example.org|
|Study Chair:||KAABACHI OLFA, PROF||KASSAB ORTHOPEDIC INSTITUTE|