Effect of SPGB on ICP and Oxygenation of Cerebral Venous Outflow in Craniotomy for Cerebral Tumors.
Effect of Sphenopalatine Ganglion Block on Intracranial Pressure and Cerebral Venous Outflow Oxygenation During Craniotomy for Supratentorial Brain Tumors.
Study Overview
Status
Status
Conditions
Conditions
Intervention / Treatment
Intervention / Treatment
Detailed Description
This study was performed in the Neurosurgical operating room and included 52 patients allocated into two groups: the treatment group (block group) and the control group (non-block group). 26 patients enrolled in block group and 26 patients in non-block group.
Intraoperative ICP monitoring by subdural ICP monitors will be done every 20 minutes in both block and non- block groups until craniotomy has been occurred, then at the time of closure of the dura . Arterio- jugular venous oxygen difference and Jugular venous bulb oxygen saturation changes will be recorded every 20 minutes in block and non- block groups throughout time of the surgery till closure of the dura.
Study Type
Study Type
Enrollment (Actual)
Enrollment
Phase
Phase
- Not Applicable
Contacts and Locations
Study Locations
-
-
-
Zagazig, Egypt, 44519
- Faculty of Medicine, Zagazig University
-
-
Participation Criteria
Eligibility Criteria
Eligibility Criteria
Ages Eligible for Study
Accepts Healthy Volunteers
Genders Eligible for Study
Description
Inclusion Criteria:
- Patients who prepared for a neurosurgical intervention for elective supratentorial tumor removal
- ASA 1 and 2
- Age above 18 years and below 65 years
- Fully conscious patients.
Exclusion Criteria:
- Patients with cardiovascular and respiratory diseases
- Pregnancy
- Patient refusal
Study Plan
How is the study designed?
Design Details
- Primary Purpose: Treatment
- Allocation: Randomized
- Interventional Model: Parallel Assignment
- Masking: Double
Number of Arms
Arms and Interventions
Participant Group / ArmParticipant Group / Arm |
Intervention / TreatmentIntervention / Treatment |
|---|---|
|
Experimental: Block group (A)
26 patients who will be subjected to a neurosurgical intervention for removal of supratentorial brain tumor. Supratentorial brain tumors with shift of the mid-line <10 mm evaluated by CT scan [computerized tomography] . SPGB will be performed using 2 % lidocaine before induction of anesthesia. The anesthesia induced by IV anesthetics and maintained by Isoflurane. ICP, Jugular venous bulb oxygen saturation, and AVDO2 will be assessed every 20 minutes. |
Sphenopalatine Ganglion Block using 2% lidocaine in block group.
Sphenopalatine Ganglion Block is performed by a hollow culture swab that is connected with a 21-gauge a syringe filled with three ml 2% lidocaine, inserted parallel to the floor of the nose until resistance is felt.
The swab is at the posterior pharyngeal wall superior to the middle turbinate.
The applicator was kept in the nostril for five to ten mins.
The same procedure is done also in the second nostril SPGB using normal saline is performed in the control group
Other Names:
|
|
Sham Comparator: control sham group (B)
26 patients who will be subjected to a neurosurgical intervention for removal of supratentorial brain tumor.
Supratentorial brain tumors with shift of the mid-line <10 mm evaluated by CT scan [computerized tomography] .
SPGB will be performed using normal saline.The anesthesia induced by IV anesthetics and maintained by Isoflurane.
ICP, Jugular venous bulb oxygen saturation, and AVDO2 will be assessed every 20 minutes
|
Sphenopalatine Ganglion Block using 2% lidocaine in block group.
Sphenopalatine Ganglion Block is performed by a hollow culture swab that is connected with a 21-gauge a syringe filled with three ml 2% lidocaine, inserted parallel to the floor of the nose until resistance is felt.
The swab is at the posterior pharyngeal wall superior to the middle turbinate.
The applicator was kept in the nostril for five to ten mins.
The same procedure is done also in the second nostril SPGB using normal saline is performed in the control group
Other Names:
|
What is the study measuring?
Primary Outcome Measures
Primary Outcome Measures
Outcome Measure |
Measure Description |
Time Frame |
|---|---|---|
|
Intracranial Pressure
Time Frame: Every 20 minutes until time of initial craniotomy, then again after the dura was sutured.
|
ICP changes checked by a subdural ICP monitor that positioned after the first burr hole at the opposite side of the tumor immediately after induction of anesthesia.
ICP monitoring will be conducted every 20 minutes until time of initial craniotomy and at time of closure of the dura.
|
Every 20 minutes until time of initial craniotomy, then again after the dura was sutured.
|
Secondary Outcome Measures
Secondary Outcome Measures
Outcome Measure |
Measure Description |
Time Frame |
|---|---|---|
|
Jugular venous bulb oxygen saturation and cerebral arteriovenous oxygen content difference.
Time Frame: Every 20 minutes throughout the operation period.
|
Jugular venous bulb oxygen saturation will be measured then AVDO2 will be calculated.
|
Every 20 minutes throughout the operation period.
|
Collaborators and Investigators
Sponsor
Sponsor
Investigators
Investigators
- Principal Investigator: Naglaa Abdelhaleem, MD, Faculty of Medicine, Zagazig University, Zagazig, Egypt.
Publications and helpful links
General Publications
- Kaye A, Kucera IJ, Heavner J, Gelb A, Anwar M, Duban M, Arif AS, Craen R, Chang CT, Trillo R, Hoffman M. The comparative effects of desflurane and isoflurane on lumbar cerebrospinal fluid pressure in patients undergoing craniotomy for supratentorial tumors. Anesth Analg. 2004 Apr;98(4):1127-1132. doi: 10.1213/01.ANE.0000105862.78906.3D. Erratum In: Anesth Analg. 2016 Mar;122(3):922. Kaye, Alan [corrected to Kaye, Alan David].
- Feldman Z, Robertson CS. Monitoring of cerebral hemodynamics with jugular bulb catheters. Crit Care Clin. 1997 Jan;13(1):51-77. doi: 10.1016/s0749-0704(05)70296-7.
Study record dates
Study Major Dates
Study Start (Actual)
Study Start
Primary Completion (Actual)
Primary Completion
Study Completion (Actual)
Study Completion
Study Registration Dates
First Submitted
First Submitted
First Submitted That Met QC Criteria
First Submitted That Met QC Criteria
First Posted (Actual)
First Posted
Study Record Updates
Last Update Posted (Actual)
Last Update Posted
Last Update Submitted That Met QC Criteria
Last Update Submitted That Met QC Criteria
Last Verified
Last Verified
More Information
Terms related to this study
Other Study ID Numbers
Other Study ID Numbers
- 6180
Plan for Individual participant data (IPD)
Plan to Share Individual Participant Data (IPD)?
IPD Plan Description
IPD Sharing Time Frame
IPD Sharing Access Criteria
IPD Sharing Supporting Information Type
- Study Protocol
- Statistical Analysis Plan (SAP)
- Informed Consent Form (ICF)
- Clinical Study Report (CSR)
- Analytic Code
Drug and device information, study documents
Studies a U.S. FDA-regulated drug product
Studies a U.S. FDA-regulated device product
product manufactured in and exported from the U.S.
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