Anesthesia, General, Cholecystectomy, Laparoscopic, Hypotension
Conditions
Keywords
Internal Jugular Vein, Collapsibility Index, IJV-CI, Ultrasonography, Post-induction Hypotension, Anesthesia Induction, Laparoscopic Cholecystectomy, Fluid Responsiveness
Brief summary
This study aims to investigate whether the Internal Jugular Vein Collapsibility Index (IJV-CI), measured via ultrasonography, can predict hypotension (low blood pressure) that occurs after the induction of general anesthesia. Researchers will measure the diameter of the internal jugular vein in patients before surgery and compare these measurements with the blood pressure changes during the first minutes of anesthesia. The goal is to determine if IJV-CI can be used as a reliable, non-invasive tool to identify patients at higher risk of developing anesthesia-induced hypotension.
Detailed description
Patients aged 18-65 scheduled for elective laparoscopic cholecystectomy under general anesthesia will be included in the study. Exclusion criteria are as follows: Obesity (BMI \> 35 kg/m²), presence of Atrial Fibrillation or serious cardiac arrhythmia, history of neck surgery or any pathology preventing internal jugular vein measurement, advanced heart failure (Ejection Fraction \< 40%), severe valvular disease, peripheral vascular disease, emergency surgery, and refusal to participate in the study. Upon arrival in the operating room, patients will be placed in a supine position. The Internal Jugular Vein (IJV) diameter will be monitored using a linear ultrasound probe during spontaneous breathing before anesthesia induction. The maximum and minimum diameters of the IJV during the respiratory cycle will be measured. The Internal Jugular Vein Collapsibility Index (IJV-CI) will be calculated using the following formula: \[(IJV maximum diameter - IJV minimum diameter) / IJV maximum diameter\] x 100. Standard anesthesia induction will be performed. Non-invasive blood pressure and heart rate will be monitored and recorded at baseline (0 min), and at 1, 2, 3, 5, 7, 9, and 10 minutes following induction. Post-induction hypotension is defined as a decrease in mean arterial pressure (MAP) of more than 20% from the baseline value. The relationship between the pre-induction IJV-CI values and the development of hypotension during these specific time intervals will be statistically analyzed.
Interventions
DIAGNOSTIC_TESTIJV-CI Measurement
Pre-induction Internal Jugular Vein (IJV) measurement will be performed using a linear ultrasound probe (5-12 MHz) while the patient is in the supine position. The IJV will be imaged in the transverse plane at the level of the cricoid cartilage. During spontaneous breathing, the maximum and minimum diameters of the vein will be recorded. The Collapsibility Index (IJV-CI) will be calculated using these measurements. This non-invasive assessment is performed immediately before the induction of general anesthesia to evaluate its predictive value for post-induction hypotension.
Sponsors
University of Gaziantep
Study design
Observational model
COHORT
Time perspective
PROSPECTIVE
Eligibility
Sex/Gender
ALL
Age
18 Years to 65 Years
Healthy volunteers
No
Inclusion criteria
* Patients aged 18-65 years. * Patients with ASA (American Society of Anesthesiologists) physical status I, II, or III. * Patients scheduled to receive general anesthesia. * Patients scheduled for elective laparoscopic cholecystectomy.
Exclusion criteria
* Patients with obesity (Body Mass Index \> 35 kg/m²). * Patients with Atrial Fibrillation or other serious cardiac arrhythmias. * Patients with a history of neck surgery or any pathology preventing Internal Jugular Vein (IJV) measurement. * Patients with advanced heart failure (Ejection Fraction \< 40%). * Patients with severe valvular heart disease. * Patients with peripheral vascular disease. * Patients undergoing emergency surgery. * Patients who are unwilling to participate in the study.
Design outcomes
Primary
| Measure | Time frame | Description |
|---|---|---|
| Internal Jugular Vein Collapsibility Index (IJV-CI) | Baseline (pre-induction) and every minute up to 10 minutes following induction or until surgical in | Hypotension is defined as a decrease in Mean Arterial Pressure (MAP) of more than 20% from the baseline value. The predictive value of pre-induction IJV-CI for this occurrence will be assessed.Measurements will be recorded at 0, 1, 2, 3, 5, 7, 9, and 10 minutes following induction, but will stop if surgical incision occurs earlier than 10 minutes |
Countries
Turkey (Türkiye)
Contacts
CONTACTELZEM ŞEN, Associate Professor
CONTACTKübra Bahar Türkmen, MD
PRINCIPAL_INVESTIGATORELZEM ŞEN, Associate Professor
Gaziantep University, Faculty of Medicine, Department of Anesthesiology and Reanimation
Outcome results
None listed