The Angle of Trendelenburg
Conditions
Brief summary
How to maintain the stability of circulation during anesthesia has always been a concern of clinicians, including shorting the preoperative fasting time under the condition of full preoperative preparation, and giving appropriate amount of nutrient solution in combination with the patient's situation 2\ 4 h before surgery to reduce the blood volume insufficiency of patients before general anesthesia induction, vasoactive drugs, etc. Among them, passive leg lifting experiment is widely recognized in the world. Although passive leg lifting has many advantages, it still has some limitations in the operation process. This study tried to find the corresponding head low and foot high Angle corresponding to the same hemodynamic changes caused by passive leg lifting.
Detailed description
For low head and high feet, studies have shown that 20° can reduce the incidence of hypotension during the induction period of general anesthesia in patients undergoing gastrectomy and has therapeutic effect on it, as well as reduce the use of vasoactive drugs during the induction period of general anesthesia. There were no perioperative complications. The passive leg lift test can be repeated and does not overload the patient with fluid. However, there is no relevant research on the relationship between the two, which is exactly the innovation of this topic.
Interventions
OTHERTrendeleburg -5 degree,-10 degree,-15 degree
Use a -5 or -10 or -15 degree trendelenburg position
Sponsors
The Second Affiliated Hospital of Dalian Medical University
Study design
Allocation
NA
Intervention model
SINGLE_GROUP
Primary purpose
TREATMENT
Masking
NONE
Eligibility
Sex/Gender
ALL
Age
18 Years to 75 Years
Healthy volunteers
No
Inclusion criteria
* Age 18\ 75 years old * Good image of TTE can be obtained * Sedative mechanical ventilation （Vt 8～10ml/kg） * Circulation was relatively stable before the experiment began * There is no contraindication to rehydration
Exclusion criteria
* TTE acquisition is not ideal * Patients did not agree to participate in the experiment * Diseases of the central nervous system，patients with increased intracranial pressure * Arrhythmia patients; * Patients with increased intra-abdominal pressure; * Bedridden patients; * Patients with venous thrombosis of lower limbs; * Patients with venous foreign body of lower limbs; * Patients with circulatory instability; * Patients with obstructive shock; * Patients with moderate or above heart valve reflux
Design outcomes
Primary
| Measure | Time frame | Description |
|---|---|---|
| PPV(pulse pressure variation) | T1:A supine position with a 10° upward bed angulation；T2: After passive leg lift；T3：The same position with T1；T4:After trendelenburg position；T5:The same position with T1;T6:After fluid infusion | Change from PPV at T1to T6 |
| VTI(velocity time integral) | T1:A supine position with a 10° upward bed angulation；T2: After passive leg lift；T3：The same position with T1；T4:After trendelenburg position；T5:The same position with T1;T6:After fluid infusion | Change from VTI at T1 to T6 |
Secondary
| Measure | Time frame | Description |
|---|---|---|
| HR HR(Heart Rate) | T1:A supine position with a 10° upward bed angulation；T2: After passive leg lift；T3：The same position with T1；T4:After trendelenburg position；T5:The same position with T1;T6:After fluid infusion | The variation tendency of T1 to T6 |
| SBP(Systolic Blood Pressure) | T1:A supine position with a 10° upward bed angulation；T2: After passive leg lift；T3：The same position with T1；T4:After trendelenburg position；T5:The same position with T1;T6:After fluid infusion | The variation tendency of T1 to T6 |
| MAP(Mean Artery Pressure) | T1:A supine position with a 10° upward bed angulation；T2: After passive leg lift；T3：The same position with T1；T4:After trendelenburg position；T5:The same position with T1;T6:After fluid infusion | The variation tendency of T1 to T6 |
Countries
China
Contacts
Primary ContactYanan Pu, Master
Backup ContactDan Hua, Master
Outcome results
None listed