Cerebral Arterial Aneurysm, Ventricular Rate Response Pacing
Conditions
Brief summary
To evaluate the effect of rapid ventricular pacing on the oxygenation of the brain in patients scheduled for cerebral aneurysm clipping surgery or arteriovenous malformation surgery.
Detailed description
Patients scheduled for cerebral aneurysm clipping surgery or arteriovenous malformation surgery(ASA 1to 3 over 18years) receive standard care general anesthesia including central venous line for rapid ventricular pacing technique. A contralateral Foresight sensor is placed on the forehead of the patient at induction. After the craniotomy two micro electrodes(PBtO2 and cerebral blood flow) are placed in the brain and fixated. A subdural strip electrode is placed on the surface of the brain to record the electrical activity. Effect of mild hyperventilation and oxygenation with 100% O2 is evaluated.
Interventions
PROCEDURESurgery
Sponsors
University Hospital, Antwerp
Study design
Allocation
NA
Intervention model
SINGLE_GROUP
Primary purpose
OTHER
Masking
NONE
Eligibility
Sex/Gender
ALL
Age
18 Years to No maximum
Healthy volunteers
No
Inclusion criteria
* scheduled for cerebral aneurysm surgery or arterial venous malformation * American Society of Anesthesiologists classification 1, 2, or 3
Exclusion criteria
* non
Design outcomes
Primary
| Measure | Time frame | Description |
|---|---|---|
| Cerebral oxygenation during surgery | During surgery | Oxygenation of the brain is measured by near-infrared spectroscopy and by evaluation of the brain tissue oxygen pressure by two microelectrodes placed in the brain. |
| Cerebral blood flow during surgery | During surgery | Thermal diffusion flowmetry measures the local absolute cerebral blood flow |
Secondary
| Measure | Time frame | Description |
|---|---|---|
| Electrophysiological changes in the brain during surgery | During surgery | Electro-corticography measures electrophysiological changes in the brain. |
| Effect of ventilation with 100 % oxygen on cerebral parameters after rapid ventricular pacing | Intraoperative ( Start of ventilation at 100% oxygen until bloodgas analyses shows an increase in arterial oxygen pressure.) | Effect of ventilation with 100% oxygen on cerebral blood flow and cerebral tissue oxygenation measured by thermal diffusion flowmetry and brain tissue oxygen pressure measured by microelectrodes placed in the brain in combination with near-infrared spectroscopy, respectively. |
| Effect of hyperventilation on cerebral parameters after rapid ventricular pacing | Intraoperative (Start of hyperventilation until bloodgas analyses shows an arterial carbon dioxide pressure between 24 and 32 millimetre of mercury.) | Effect of hyperventilation (defined as arterial carbon dioxide pressure between 24 and 32 millimeter mercury) on cerebral blood flow and cerebral tissue oxygenation measured by thermal diffusion flowmetry and brain tissue oxygen pressure measured by microelectrodes placed in the brain in combination with near-infrared spectroscopy, respectively. |
Countries
Belgium
Outcome results
None listed