Hypotensive Effect of Anaesthesia With TCI (HEAT)
The Effect of Target Controlled Infusion as Opposed to Velocity Controlled Infusion on Hypotension at Induction of Total Intravenous Anaesthesia
Studieoversigt
Status
Status
Betingelser
Betingelser
Intervention / Behandling
Intervention / Behandling
Detaljeret beskrivelse
Severe hypotension may be a serious complication to induction of anaesthesia. The patients preoperative clinical circulatory status will help define the risks of such a side-effect. A patient with a preexisting heart condition will be at increased risk for morbidity/mortality in relation to anaesthesia induction.
Total intravenous anaesthesia may be delivered by two different approaches. The old way where the drug (Propofol and/or Remifentanil) is delivered in a velocity (mg/kg x hour or microg/ kg x min) specified by the anaesthetist. Hereafter called Velocity Controlled Infusion (VCI). At induction, to get effect of the drug, a high infusion rate is desired. A high infusion rate is associated with increased risks of hypotension if it is not adjusted in accordance with the current circulatory status of the patient. A failure to adjust may be futile for the patient. Therefore, induction takes some time because infusion rate is set within a relatively safe range. After a few minutes, once airway control is achieved, the infusion rate must be adjusted down to avoid hypotension.
There is a more modern way of adjusting the infusion rate, the so called Target Controlled Infusion. With this approach, the pump delivering the drug will help the anaesthetist to select the appropriate infusion rate for any given situation. The anaesthetist selects a preferred concentration of the drug at the target, that is in the circulation. The pump then administrates the drug, first at high rate and then at lower rate, taking into account the patients age, weight and sex and the preferred target concentration.
It is possible that this help from the machine is associated with less risk for hypotension at anaesthesia induction. If this is so it would have an impact on which of TCI and VCI that would be the best choice of anaesthesia. This would have special impact when giving anaesthesia to patients with a heart condition.
Undersøgelsestype
Undersøgelsestype
Tilmelding (Faktiske)
Tilmelding
Fase
Fase
- Ikke anvendelig
Kontakter og lokationer
Studiesteder
-
-
Alberta
-
Östersund, Alberta, Sverige, 83183
- Östersund Hospital
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-
Deltagelseskriterier
Berettigelseskriterier
Berettigelseskriterier
Aldre berettiget til at studere
Tager imod sunde frivillige
Køn, der er berettiget til at studere
Beskrivelse
Inclusion Criteria:
* All patients scheduled for anaesthesia at Östersunds Hospital
- ASA class I-II
Exclusion Criteria:
- On beforehand decision to start continous delivery of blood pressure increasing drug at induction.
- Any contraindication to Total Intravenous Anaesthesia
Studieplan
Hvordan er undersøgelsen tilrettelagt?
Design detaljer
- Primært formål: Andet
- Tildeling: Randomiseret
- Interventionel model: Parallel tildeling
- Maskning: Enkelt
Antal våben
Våben og indgreb
Deltagergruppe / ArmDeltagergruppe / Arm |
Intervention / BehandlingIntervention / Behandling |
|---|---|
|
Andet: Target Controlled Infusion
This group of patients will have their anaesthesia induced with Target Controlled Infusion (TCI)
|
|
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Andet: Velocity Controlled Infusion
This group of patients will have their anaesthesia induced with Velocity Controlled Infusion (VCI)
|
Hvad måler undersøgelsen?
Primære resultatmål
Primære resultatmål
Resultatmål |
Foranstaltningsbeskrivelse |
Tidsramme |
|---|---|---|
|
Hypotension
Tidsramme: 20 minutes
|
Relative maximal decrease of blood pressure (in mmHg) by anaesthesia induction (%)
|
20 minutes
|
Sekundære resultatmål
Sekundære resultatmål
Resultatmål |
Foranstaltningsbeskrivelse |
Tidsramme |
|---|---|---|
|
Pharmacological measures to increase blood pressure
Tidsramme: 20 minutes
|
Number of doses of drug to increase blood pressure
|
20 minutes
|
|
Drug consumption
Tidsramme: From the start of anaesthesia induction to the time of airway control (Laryngeal airway working in place of tracheal tube working in place).
|
Amount (milligram) of Propofol delivered and amount (mikrogram) of Remifentanil delivered.
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From the start of anaesthesia induction to the time of airway control (Laryngeal airway working in place of tracheal tube working in place).
|
|
PONV (Postoperative Nausea and Vomiting)
Tidsramme: From end of anaesthesia to 2 hours or when leaving the PostAnaesthesia Care Unit
|
Dose and name of any drug given to reduce PONV at any time defined above (in addition to profylaxis with the same aim)
|
From end of anaesthesia to 2 hours or when leaving the PostAnaesthesia Care Unit
|
Samarbejdspartnere og efterforskere
Sponsor
Sponsor
Datoer for undersøgelser
Studer store datoer
Studiestart
Studiestart
Primær færdiggørelse (Faktiske)
Primær færdiggørelse
Studieafslutning (Faktiske)
Studieafslutning
Datoer for studieregistrering
Først indsendt
Først indsendt
Først indsendt, der opfyldte QC-kriterier
Først indsendt, der opfyldte QC-kriterier
Først opslået (Skøn)
Først opslået
Opdateringer af undersøgelsesjournaler
Sidste opdatering sendt (Faktiske)
Sidste opdatering sendt
Sidste opdatering indsendt, der opfyldte kvalitetskontrolkriterier
Sidste opdatering indsendt, der opfyldte kvalitetskontrolkriterier
Sidst verificeret
Sidst verificeret
Mere information
Begreber relateret til denne undersøgelse
Yderligere relevante MeSH-vilkår
Andre undersøgelses-id-numre
Andre undersøgelses-id-numre
- TCI hypotension TIVA
Plan for individuelle deltagerdata (IPD)
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