Perioperative hypotension in elderly patients undergoing laparoscopic abdominal surgery
Conditions
Interventions
Titrated group:Anesthesia induction was performed by continuous infusion of propofol at a rate of 3 mg/kg/h, combined with remifentanil at 1.2 µg/kg, until the patient lost consciousness, as indicated
Controled group:Routine induction and maintenance were performed using remimazolam and remifentanil.
Remimazolam was administered at an initial dose of 0.2 mg/kg for induction. Following endotracheal
however, the monitor screen was positioned facing away from the anesthesiologist.
Sponsors
The Sixth Affiliated Hospital of Sun Yat-sen University
Eligibility
Sex/Gender
All
Age
65 Years to No maximum
Inclusion criteria
Inclusion criteria: 1. Age >= 65 years old, scheduled for elective laparoscopic abdominal surgery 2. ASA grade 1-3 3. Requiring invasive arterial blood pressure monitoring
Exclusion criteria
Exclusion criteria: 1. Patients currently participating in other clinical trials that may affect the interventions or observations of this study will be excluded. 2. Those with severe liver or kidney disease (GFR= 180 mmHg or DBP >= 110 mmHg); 4. Patients with severe mental disorders (such as schizophrenia), epilepsy, or Parkinson’s disease, severe cognitive or intellectual impairment, severe visual or hearing impairments affecting assessment, or long-term alcohol abuse or use of sedative/analgesic medications; 5. Patients with a history of allergy to the drugs used in this study; 6. Patients requiring continuous intravenous vasoconstrictors before the start of surgery, or those whose blood pressure needs prolonged regulation and intervention during surgery due to surgical reasons; 7. Expected blood loss > 15% of total blood volume; 8. Expected surgical duration 6 hours; 9. Expected postoperative hospital stay < 72 hours.
Design outcomes
Primary
| Measure | Time frame |
|---|---|
| Rate of hypotension; | — |
Secondary
| Measure | Time frame |
|---|---|
| The time-weighted area under the curve (TWA) for MAP <65 mmHg during the anesthesia period;Cumulative dose of norepinephrine and the proportion of patients requiring vasoactive support;;The time-weighted area under the curve (TWA) for MAP <0.8 baseline during the anesthesia period;Time to first hypotensive episode;Cardiac index(CI) trend ;The time periods with a higher incidence of hypotension between the two groups;Intraoperative ciprofol and remifentanil dose per unit time;Whether blood pressure variability (CV) and the average rate of blood pressure variation (ARV) are different.;The incidence of severe intraoperative hypotension;The time from general anesthesia drug discontinuation to awakening.;The rate of postoperative delirium;Postoperative complications;The mortality rate and readmission rate within 30 days after the operation.;The lowest MAP during surgery ; | — |
Countries
China
Contacts
Public ContactJin Sanqing
The Sixth Affiliated Hospital of Sun Yat-sen University
Outcome results
None listed