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Cardiac Output and Other Hemodynamic Changes With Prone Position in Cervical Myelopathy Patients Undergoing Surgery

Cardiac Output and Other Hemodynamic Changes With Prone Position in Cervical Myelopathy Patients Undergoing Surgery

Status
Completed
Phases
Unknown
Study type
Observational
Source
ClinicalTrials.gov
Registry ID
NCT03027817
Enrollment
30
Registered
2017-01-23
Start date
2014-11-30
Completion date
2015-12-31
Last updated
2017-01-23

For informational purposes only — not medical advice. Sourced from public registries and may not reflect the latest updates. Terms

Conditions

Hemodynamics Instability

Keywords

Prone positioning, Non-invasive Cardiac Output Monitoring

Brief summary

Positioning a patient in prone position under anaesthesia significantly alters cardiovascular physiology. Cervical myelopathy patients are known to have autonomic dysfunction. Such patients when positioned in prone position under anaesthesia carry a higher risk of developing hemodynamic changes and this can compromise spinal cord perfusion. This prospective observational study was conducted on 30 patients with cervical myelopathy who underwent surgery in prone position at NIMHANS, Bangalore hospital. The non invasive cardiac output monitor (NICOM, Cheetah Medicals) was used to record various hemodynamic parameters. The hemodynamic parameters were recorded at baseline, post induction, post intubation, prior to prone position, post prone position, and every five minutes thereafter upto 20mins. The hemodynamic parameters that were recorded using the NICOM monitor: * HR - Heart rate (beats /min) * NIBP - non invasive blood pressure (mmHg) * MAP - mean arterial pressure(mmHg) * CO - cardiac output (l/min) * CI - cardiac index (l/min/m2) * SV - Stroke volume (ml/beat) * SVV -stroke volume variability (%) * TPR - total peripheral resistance (dynes. sec/cm5)

Interventions

PROCEDUREProne Positioning

Noninvasive cardiac output monitoring parameters were recorded before and after prone positioning.

Sponsors

Dhritiman Chakrabarti
Lead SponsorOTHER

Study design

Observational model
COHORT
Time perspective
PROSPECTIVE

Eligibility

Sex/Gender
ALL
Age
18 Years to 65 Years
Healthy volunteers
No

Inclusion criteria

Cervical myelopathy patients undergoing surgery in prone position with: * ASA Class I , II and III * Age between 18 to 65 years * Nurick's grade 2 or more

Exclusion criteria

* Atlanto occipital dislocation and cervicomedullary junction pathology * Tumour pathology * Diabetic patients * Patients positioned prone in the awake state (without induction of anaesthesia)

Design outcomes

Primary

MeasureTime frameDescription
Mean arterial pressureBefore induction of anaesthesia to 20 minutes after prone positioning (end of study)Analysis of change in mean arterial pressure at following time points - before induction of anaesthesia, 2 minutes after anaesthetic induction, 2 minutes after intubation, before turning prone, immediately after turning prone and every 5 minutes thereafter till 20 minutes after positioning.

Secondary

MeasureTime frameDescription
Heart rateBefore induction of anaesthesia to 20 minutes after prone positioning (end of study)Analysis of change in heart rate at following time points - before induction of anaesthesia, 2 minutes after anaesthetic induction, 2 minutes after intubation, before turning prone, immediately after turning prone and every 5 minutes thereafter till 20 minutes after positioning.
Cardiac outputBefore induction of anaesthesia to 20 minutes after prone positioning (end of study)Analysis of change in cardiac output at following time points - before induction of anaesthesia, 2 minutes after anaesthetic induction, 2 minutes after intubation, before turning prone, immediately after turning prone and every 5 minutes thereafter till 20 minutes after positioning.
Stroke volumeBefore induction of anaesthesia to 20 minutes after prone positioning (end of study)Analysis of change in stroke volume at following time points - before induction of anaesthesia, 2 minutes after anaesthetic induction, 2 minutes after intubation, before turning prone, immediately after turning prone and every 5 minutes thereafter till 20 minutes after positioning.
Stroke volume variationBefore induction of anaesthesia to 20 minutes after prone positioning (end of study)Analysis of change in stroke volume variation at following time points - before induction of anaesthesia, 2 minutes after anaesthetic induction, 2 minutes after intubation, before turning prone, immediately after turning prone and every 5 minutes thereafter till 20 minutes after positioning.
Total peripheral resistanceBefore induction of anaesthesia to 20 minutes after prone positioning (end of study)Analysis of change in total peripheral resistance at following time points - before induction of anaesthesia, 2 minutes after anaesthetic induction, 2 minutes after intubation, before turning prone, immediately after turning prone and every 5 minutes thereafter till 20 minutes after positioning.

Outcome results

None listed

Source: ClinicalTrials.gov · Data processed: Feb 4, 2026