Anesthesia, Hemodynamic Instability, Shoulder Injuries
Conditions
Keywords
beach chair position, arthroscopic shoulder surgery, preloading, hemodynamic stability, postoperative nausea and vomiting
Brief summary
The main objective of this study is whether preloading before positioning would be effective for less hemodynamic instability. The study also analyzes that patients with preloading will decrease postoperative nausea and vomiting, better surgical satisfaction and shortened the duration of surgery and anesthesia.
Detailed description
Keeping patients in normovolemic state and hemodynamically stable in anesthesia and intensive care practice are important goals of anesthesiologist. It is known that hypotension that develops after taking patients to the beach chair position has a negative effect on cerebral oxygenation. Aggressive fluid regimes using to prevent hypotension can cause glycocalyx damage, edema and organ dysfunction. Also hypertension seconday to vasopressor therapy can cause bleeding at the surgical site and impaired surgical visualization during the arthroscopic shoulder surgery. In the literature, there are studies examine whether the hypotension is the result of decreased cardiac output or decreased systemic resistance and what should be the optimal treatment , but as far as investigators know, there is no study about effects of preloading before the beach chair position on hemodynamic parameters.
Interventions
DRUGPreloading with crystalloid fluid
crystalloid fluid at 10 ml/kg of ideal body weight was administered intravenously in 30 min before the BCP for patients
Sponsors
Istanbul University
Study design
Allocation
RANDOMIZED
Intervention model
PARALLEL
Primary purpose
TREATMENT
Masking
SINGLE (Subject)
Masking description
Single-blind
Intervention model description
Study group - Control group
Eligibility
Sex/Gender
ALL
Age
18 Years to 65 Years
Healthy volunteers
Yes
Inclusion criteria
* undergoing elective arthroscopic shoulder surgery in the BCP, * age older than 18 years and younger than 65 years, * the American Society of Anesthesiologist (ASA) physical status of I or II, * accepting the study protocol.
Exclusion criteria
* preoperative arrhythmia, * significant heart failure * valvular heart disease, * preexisting cerebrovascular disease, * deciding to switch to open surgery, * vasopressor infusion during the surgery, * using angiotensin converting enzyme inhibitors (ACEI) orangiotensin receptor blockers (ARB) as antihypertensive medication.
Design outcomes
Primary
| Measure | Time frame | Description |
|---|---|---|
| Mean arterial pressure | during surgery (spesicific time intervals (after induction - after BCP position - 0th min - 5th min - 10th min- 30th min- 60th min) | (mmHg) |
| Cardiac output | during surgery (spesicific time intervals (after induction - after BCP position - 0th min - 5th min - 10th min- 30th min- 60th min) | (L/min) |
| Stroke volume variation | during surgery (spesicific time intervals (after induction - after BCP position - 0th min - 5th min - 10th min- 30th min- 60th min) | (%) data obtained from arterial contour analysis |
| Heart rate | during surgery (spesicific time intervals (after induction - after BCP position - 0th min - 5th min - 10th min- 30th min- 60th min) | bpm |
Secondary
| Measure | Time frame | Description |
|---|---|---|
| Postoperative nausea and vomiting | in postoperative first day | PONV rates |
| Total amount of crystalloid and colloid | during surgery | Total amount of crystalloid and colloid (ml) |
| Surgical satisfaction rate | in postoperative first day | Surgical satisfaction scale (0-10, 0 lowest score, 10 highest score) (score) |
| The duration of anesthesia and surgery | during surgery | The duration of anesthesia and surgery (min) |
| Ephedrine usage | during surgery | total ephedrine dose (mg) used during surgery |
Countries
Turkey (Türkiye)
Outcome results
None listed