Anesthesia, ERAS, Fluid Overload, Hypovolemia; Surgical Shock
Conditions
Brief summary
Controlling the amount of fluids given to patients in perioperative setting can significantly influence their outcomes.
Detailed description
To overcome these problems and avoid the complications of over or underhydration, we use the Goal-directed fluid therapy(GDFT) guided by Inferior vena cava(IVC) collapsibility index approach in which dynamic parameters of volume responsiveness as a guide for fluid therapy. This will ensure that the fluids given were deficient from the circulation and improve the recovery of the patients according to enhanced recovery after surgery(ERAS) protocols.
Interventions
PROCEDUREGoal-Directed Fluid Therapy guided by Inferior Vena Cava Collapsibility Index
Measuring Inferior vena cava(IVC) diameter using ultrasound then calculation Inferior vena cava(IVC) collapsibility index and administer fluid accordingly.
PROCEDUREstandard fluid management
standard fluid management
Sponsors
Zagazig University
Study design
Allocation
RANDOMIZED
Intervention model
PARALLEL
Primary purpose
PREVENTION
Masking
DOUBLE (Subject, Outcomes Assessor)
Eligibility
Sex/Gender
ALL
Age
21 Years to 65 Years
Healthy volunteers
Yes
Inclusion criteria
* Patient's acceptance. * Patients planned for elective lower limb surgery under spinal anesthesia. * Both sexes * Body Mass Index(BMI): \<35 * Age: 21 \ 65 years * American Society of Anesthesiologists(ASA) Physical Status Classification System: Class I & II * Duration of surgery 2\ 3 hours
Exclusion criteria
* Advanced kidney, liver, respiratory or cardiovascular disease. * Contraindication for spinal anesthesia. * Patients shifted to general anesthesia for any reason.
Design outcomes
Primary
| Measure | Time frame | Description |
|---|---|---|
| Post Anesthesia Care Unit(PACU) Stay | 2 hours postoperatively | time spent in PACU after surgery measured in minutes |
| Mean Arterial Blood Pressure | intraoperatively every 5 minutes | intraoperative mean arterial blood pressure measured in mmHg |
| Quality of Recovery-40 score(QoR-40) | 24 hours postoperative | QoR-40 score ranges from 40 to 200, the higher the score the better the outcome |
| Heart Rate | intraoperatively every 5 minutes | intraoperative heart rate will be continuously monitored and recorded every 5 minutes |
Secondary
| Measure | Time frame | Description |
|---|---|---|
| Total fluid intake during operation | intraoperatively | Total fluid intake during operation |
| Number of patients that needed Ephedrine or Atropine | intraoperatively | Number of patients that needed Ephedrine or Atropine intraoperatively |
| Peripheral perfusion index | Intraoperatively | Peripheral Perfusion Index (PPI) is defined as the ratio of pulsatile blood flow to the non-pulsatile blood flow. It ranges from 0.02% to 20% and it is measured using specific types pulse oximetry and it reflects the perfusion status of the body. |
| Length of hospital stay | the patient will be followed up for 60 days from day of surgery | the number of days from day of surgery until patient's discharge from hospital |
Contacts
Primary ContactMahmoud Abdelkader, MBBCh
Backup ContactAlshaimaa Kamel, MD.
Outcome results
None listed