Blood Pressure, Cognitive Impairment, Femoral Fracture
Conditions
Keywords
Anaesthesia, spinal, Cerebral oximetry, Blood pressure, Heart rate, Cognitive Symptom
Brief summary
The aim of this study is to observe how the hemodynamic changes induced by spinal blockade affect cerebral oxygenation. Elderly patients are very frail. Hypotension is very frequent during spinal anaesthesia. Bradycardia is other side effect of regional anaesthesia affecting cardiac output and cerebral blood flow. These complications of spinal anaesthesia could decline cognitive function. In this way a non invasive monitoring technique as cerebral oximetry is useful for the safety of anesthetic procedure.
Detailed description
Patients aged 70 years old with hip fracture presenting for surgical repair under intrathecal anaesthesia performed with bupivacaine or L bupivacaine (dose 7 - 9 mg). Preoperative haemoglobin and drugs consumption are registered. All patients receive supplemental oxygen during surgery. Cerebral oximetry, blood pressure, heart rate and oxygen arterial saturation are measured. Level and duration of sensory and motor block are registered. The study observes if there is any correlation between cerebral oximetry and these hemodynamic parameters. The investigators also observe if there is any correlation between cerebral oximetry and cognitive function evaluated pre and postoperatively by SPMSQ test. Postoperative SPMSQ test will be performed on the 5th postoperative day and the complications registered.Patients will be followed for the duration of acute hospital stay.
Interventions
None listed
Sponsors
Hospital de Sabadell
Study design
Observational model
COHORT
Time perspective
PROSPECTIVE
Eligibility
Sex/Gender
ALL
Age
70 Years to No maximum
Healthy volunteers
No
Inclusion criteria
* Patients aged \>70 years old with hip fracture. * No contraindication for spinal anaesthesia.
Exclusion criteria
* Allergic reaction to local anesthetics. * Severe aortic stenosis. * Local infection. * SPMSQ test \>7 errors. * Patient refusal
Design outcomes
Primary
| Measure | Time frame | Description |
|---|---|---|
| Cerebral Oximetry | Initial, 3 times after spinal block and every 10 minutes during surgery | Changes in cerebral oxymetry measured initially (basal), 10, 20 and 30 minutes after spinal block. During surgery oximetry is measured evey 10 minutes to obtain the mean of all the values. |
| Mean Arterial Pressure (MAP) | Initial, 3 times after spinal block and every 10 minutes during surgery | Changes in MAP measured initially (basal), 10, 20 and 30 minutes after spinal block. During surgery oximetry is measured every 10 minutes to obtain the mean of all the values |
| Heart Rate (HR) | Initial, 3 times after spinal block and every 10 minutes during surgery | Changes in HR (basal), 10, 20 and 30 minutes after spinal block. During surgery oximetry is measured every 10 minutes to obtain the mean of all the values. |
| Oxygen arterial saturation (OSat) | Initial, 3 times after spinal block and every 10 minutes during surgery | Changes in OSat measured initially (basal), 10, 20 and 30 minutes after spinal block. During surgery oximetry is measured every 10 minutes to obtain the mean of all the values. |
Secondary
| Measure | Time frame | Description |
|---|---|---|
| Short Portable Mental Status Questionnaire (SPMSQ) | Once before surgery and at 5th postoperative day | This test measures cognitive impairment before and after surgery |
Countries
Spain
Contacts
Primary ContactDiana L Fernández Galinski, PhD
Backup ContactFrancisca Gordo Lacal, Dr
Outcome results
None listed