Airway Reactivity, Hemodynamic Stability During Anesthesia
Conditions
Keywords
Physiology-guided airway preparation, Standard oxygen therapy, Hemodynamic stability, Cerebral oximetry, Spinal surgery anesthesia
Brief summary
This study looked at a safer way to prepare patients for anesthesia before major spinal surgery. Instead of using advanced or complex oxygen devices, the approach will use standard oxygen methods, guided by the patient's individual physiological responses (such as oxygen levels and circulation).
Detailed description
We therefore compared conventional mechanical ventilation via a face mask with ventilation adjusted to maintain ETCO₂ at 40-45 mmHg during induction of general anaesthesia for major spinal surgery. We hypothesized that ETCO₂ targeting would reduce the fall in cerebral oxygenation from the post-preoxygenation baseline.
Interventions
PROCEDUREregional cerebral oxygen saturation
By employing multi-wavelength technology on the forehead, the O3 device provides clinicians with crucial insights into the balance between cerebral oxygen demand and supply. This monitoring is especially valuable for high-risk patient populations, such as those undergoing cardiac surgery, and patients in the intensive care unit (ICU), which provides a continuous, non-invasive assessment of rSO₂ enabling the prompt detection of critical desaturation events. Crucially, changes in rSO₂ during induction correlate with factors directly relevant to spinal cord safety, such as hypotension, hypocapnia, and reduced cardiac output.
Sponsors
Prince Sultan Military Medical City
Study design
Observational model
COHORT
Time perspective
PROSPECTIVE
Eligibility
Sex/Gender
ALL
Age
18 Years to 70 Years
Healthy volunteers
No
Inclusion criteria
* Major spinal surgery * Under general anesthesia
Exclusion criteria
* Left ventricular ejection fraction \< 35% * Known intracranial pathology * Severe pulmonary disease * Body mass index \>40 kg•m-² * Emergency surgery * Planned awake intubation * Known autonomic dysfunction
Design outcomes
Primary
| Measure | Time frame | Description |
|---|---|---|
| The baseline-to-minimum post-baseline rSO₂ difference, | MAP will be recorded non-invasively at four specific time points: 1 Baseline (before airway preparation) 2 Immediately before intubation 3 Immediately after intubation 4 Five minutes after intubation | The baseline-to-minimum post-baseline rSO₂ difference, calculated as: T₀ rSO₂ - minimum rSO₂ recorded from T₁ to T₆ |
Secondary
| Measure | Time frame | Description |
|---|---|---|
| Incidence of cerebral oxygen desaturation | During endotracheal intubation | ≥20% decrease in rSO₂ from baseline |
Countries
Saudi Arabia
Contacts
STUDY_DIRECTORMuteb AlOtaibi, MD
Prince Sultan Military Medical City
Outcome results
None listed