Ultrasonographic Evaluation of Internal Jugular Vein Cross Sectional Area for Prediction of Post Spinal Hypotension

Ultrasonographic Evaluation of Internal Jugular Vein Cross Sectional Area for Prediction of Post Spinal Hypotension in Patients Undergoing Orthopedic Surgeries

The aim of this study is to evaluate the efficacy of internal jugular cross sectional area for predicting the occurrence of PSAH.

Study Overview

• Status: Completed
• Conditions: Post-spinal Anesthesia Hypotension
• Intervention / Treatment: Diagnostic test: Ultrasonographic Evaluation of Internal Jugular Vein Cross Sectional Area

Detailed Description

The aim of this study is to evaluate the efficacy of internal jugular cross sectional area for predicting the occurrence of PSAH. Spinal anaesthesia is frequently used in daily clinical practice. Postspinal anaesthesia hypotension (PSAH) is a common side effect with an incidence of 15.3 to 33% that may result in organ hypoperfusion and ischaemic events. Patients' susceptibility to intraoperative hypotension can be influenced by the sensory block level, age, preoperative volume status , physical status, pre-operative medications and fasting.

PSAH due to spinal blockade is principally a consequence of diminished systemic vascular resistance after blockade of preganglionic sympathetic fibres. Many attempts have been tried to prevent PSAH, such as intravenous volume preload or prophylactic vasopressors. However, fluid infusion has been proved to lower the incidence of PSAH and significantly decrease vasopressor requirements. At the same time, empirical volume loading carries the potential of volume overload, particularly in patients with cardiac disease. Consequently, the search for predictors of PSAH is becoming mandatory to avoid blind volume loading and reserve it only for patients who are expected to develop PSAH. .

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• Study Type: Observational
• Enrollment (Actual): 62

Contacts and Locations

Study Locations

• Egypt
  • القاهرة
    • Cairo, القاهرة, Egypt
      • Ain Shams University Hospital

Participation Criteria

Eligibility Criteria

• Ages Eligible for Study: 40 years and older (Adult, Older Adult)
• Accepts Healthy Volunteers: No
• Genders Eligible for Study: All

• Sampling Method: Non-Probability Sample

Study Population

patients more than 40 years of age with American Society of Anesthesiologists' (ASA) physical status 1 or 2 who will be scheduled for elective orthopedic surgery under spinal anaesthesia in the supine position

Description

Inclusion Criteria:

• patients more than 40 years of age.
• American Society of Anesthesiologists' (ASA) physical status 1 or 2.
• scheduled for elective surgery under spinal anaesthesia in the supine position.

Exclusion Criteria:

• BMI more than 35 kg m2.
• taking angiotensin converting enzyme inhibitors.
• pregnant women.
• emergency cases.
• absolute or relative contraindications to spinal anaesthesia.
• Also, patients with a baseline arterial systolic blood pressure less than 90 mmHg or mean arterial blood pressure (MBP) less than 70 mmHg will be excluded.

Study Plan

How is the study designed?

Design Details

• Observational Models: Ecologic or Community
• Time Perspectives: Prospective

What is the study measuring?

Primary Outcome Measures

Outcome Measure	Measure Description	Time Frame
Predictive value of internal jugular vein (IJV) cross sectional area.	The primary outcome is to evaluate the predictive value of internal jugular diameter cross sectional area for detecting PSAH	30 minutes

Collaborators and Investigators

• Sponsor: Ain Shams University
• Investigators: Principal Investigator: Sanaa Farag Mahmoud, MD, Anesthesiology department, Faculty of Medicine, Ain Shams University; Principal Investigator: Eman Sabek, MD, Radiology department, National Centre of Radiation Research and Technology, Atomic Energy Authority; Principal Investigator: WALID Nofal, MD, Anesthesiology department, Faculty of Medicine, Ain Shams Unive

Study record dates

Study Major Dates

• Study Start (Actual): March 1, 2021
• Primary Completion (Actual): July 21, 2021
• Study Completion (Actual): July 21, 2021

Study Registration Dates

• First Submitted: February 28, 2021
• First Submitted That Met QC Criteria: March 2, 2021
• First Posted (Actual): March 3, 2021

Study Record Updates

• Last Update Posted (Actual): July 23, 2021
• Last Update Submitted That Met QC Criteria: July 22, 2021
• Last Verified: July 1, 2021

More Information

Terms related to this study

• Keywords: ultrasound; Hypotension; spinal anesthesia; internal jugular vein
• Additional Relevant MeSH Terms: Cardiovascular Diseases; Vascular Diseases; Hypotension
• Other Study ID Numbers: FMASU R 25/2020/2021

Plan for Individual participant data (IPD)

• Plan to Share Individual Participant Data (IPD)?: No

Drug and device information, study documents

• Studies a U.S. FDA-regulated drug product: No
• Studies a U.S. FDA-regulated device product: No
• product manufactured in and exported from the U.S.: No