Anesthesia Percutaneous Dilation Tracheostomy S06 I61 I60
Conditions
Interventions
Group 1: Combined opioid-free anesthesia: sodium thiopental 5 mg/kg bolus and 7 mg/kg/h infusion or in patients already on thiopental dose increase to 7 mg/kg/h
pipecuronium bromide 0,04-0,06 mg/kg
local anesthesia (upper laryngeal nerves, recurrent laryngeal nerves through cricothyroid membrane, surgical site infiltration)
Group 2: Total intravenous anesthesia: sodium thiopental 5 mg/kg bolus a
fentanyl bolus 3-5 mkg/kg
Sponsors
Elizavetinskaya bolnitsa
Eligibility
Sex/Gender
All
Age
18 Years to 65 Years
Inclusion criteria
Inclusion criteria: intracranial injury, intracerebral hemorrhage, subarachnoid hemorrhage, severe acute brain injury (Glasgow Coma Scale on admission 3-8)
Exclusion criteria
Exclusion criteria: patients with bilateral fixed and dilated pupils, infusion of vasopressors or inotropic drugs at the moment of including, short cricosternal distance (less than 2,5 cm), coagulopathy (INR>1,5; APTT>55s; Fibrinogen<1,5g/l; platelets count < 100 pl/mkl ),chronic cardiovascular diseases (coronary artery disease, history of myocardial infarction, congestive heart failure, atrial fibrillation, a history (more than 1 month) of antihypertensive and antiarrhythmic drugs intake)
Design outcomes
Primary
| Measure | Time frame |
|---|---|
| stress-response [time frame: from endotracheal tube positioning till tracheostomy tube is inserted] combined end-point: mean-arterial blood pressure or heart rate rise more than 20% from baseline (mean-arterial blood pressure and heart rate after anesthesia induction but before endotracheal tube positioning) | — |
Secondary
| Measure | Time frame |
|---|---|
| - arterial blood pressure rise [time frame: from endotracheal tube positioning till tracheostomy tube is inserted] arterial blood pressure (measured non-invasively with 2 minutes interval) rise proportion - heart rate rise [time frame: from endotracheal tube positioning till tracheostomy tube is inserted] heart rate (measured continuously) rise proportion - arterial blood pressure fall[time frame: from anesthesia induction till the start of an endotracheal tube positioning] arterial blood pressure (measured non-invasively with 2 minutes interval) rise proportion - anesthesia time [time frame: from thiopental bolus or speed rise till tracheostomy tube is inserted] anesthesia time measured in seconds within time frame - lidocain systemic toxicity [time frame: from lidocain injection till tracheostomy tube is inserted] lidocain systemic toxicity signes including abrupt blood pressure fall, arrhythmia (bradycardia, extrasystolia), seizures | — |
Countries
Russia
Contacts
Public ContactDmitry Averyanov
Russian Military Medical Academy
Outcome results
None listed