None listed
Conditions
Brief summary
During shoulder surgery patients are positioned into an upright sitting position for optimal access to the shoulder joint. In some patients blood pressure may become low during surgery and a concern of the anaesthetist is whether sufficient blood reaches vital organs, including the brain. Chronic disease such as hypertension can alter the size and shape of a patient’s heart, placing them more at risk of low blood pressure during surgery. This study aims to assess the heart with ultrasound before surgery and to further examine the heart during surgery. This examination will enable the anaesthetist to anticipate a major change in blood pressure and treat it effectively. Such information can be used to better protect the patient.
Interventions
Echocardiography will be performed before surgery to assess cardiac function, and repeated following beachchair placement after anaesthetic induction. In our experience significant hypotension usually occurs within 5-10minutes following beachchair positioning, Echocardiography is performed at this time to identify changes in cardiac function relating to low blood pressure, and can contribute to vasopressor management. Haemodynamic monitoring is continuous during surgery and management is directe
Echocardiography will be performed before surgery to assess cardiac function, and repeated following beachchair placement after anaesthetic induction. In our experience significant hypotension usually occurs within 5-10minutes following beachchair positioning, Echocardiography is performed at this time to identify changes in cardiac function relating to low blood pressure, and can contribute to vasopressor management. Haemodynamic monitoring is continuous during surgery and management is directed to ensure adequate cerebral perfusion. Repeated examination may be an option in individual patients with protracted hypotension.
Sponsors
The University of Melbourne
Eligibility
Sex/Gender
All
Age
18 Years to 80 Years
Healthy volunteers
No
Inclusion criteria
Patients with a history of hypertension with current medication or athletes with history of endurance training scheduled for elective shoulder surgery. An equal number of patients without treatment for hypertension/endurance training will be recruited for comparison.
Exclusion criteria
Patients will be excluded if there is a history of cerebrovascular event, significant cardiac disease (New York Heart Association symptoms class 3, or pacemaker), carotid endarterectomy, contraindications to interscalene block, or a body mass index (BMI) of >35.
Outcome results
None listed