Gastrointestinal Tumor Surgery, Post-induction Hypotension (PIH)
Conditions
Keywords
Carotid Doppler, Passive Leg Raise, Post-induction Hypotension, Anesthesia İnduction
Brief summary
This prospective study aims to investigate the role of the passive leg raise maneuver prior to anesthesia induction in predicting post-induction hypotension among elective gastrointestinal tumor surgery patients using carotid artery Doppler parameters.
Detailed description
The study will be conducted on patients scheduled for elective gastrointestinal tumor surgery. Prior to anesthesia induction, a passive leg raise maneuver will be performed. Carotid artery Doppler parameters and hemodynamic changes will be measured and recorded to evaluate their efficacy in predicting subsequent post-induction hypotension.
Interventions
None listed
Sponsors
Ankara City Hospital Bilkent
Study design
Observational model
COHORT
Time perspective
PROSPECTIVE
Eligibility
Sex/Gender
ALL
Age
18 Years to No maximum
Healthy volunteers
No
Inclusion criteria
* Adults aged 18 years or older * Patients scheduled for elective gastrointestinal tumor surgery * Surgery planned under general anesthesia * Body mass index (BMI) \<40 kg/m² * Written informed consent provided
Exclusion criteria
* Refusal to participate or inability to obtain written informed consent * BMI ≥40 kg/m² * Pregnancy * Emergency surgery * Difficult intubation * ASA physical status ≥IV * Pediatric patients (\<18 years) * Inability to perform carotid Doppler measurements * Arrhythmia other than continuous sinus rhythm or uncontrolled cardiac arrhythmia * Severe cardiac dysfunction or left ventricular ejection fraction \<40% * Severe valvular heart disease * Clinically significant autonomic nervous system disorders * Inadequate noninvasive blood pressure monitoring or inability to obtain the required hemodynamic measurements * Active sepsis or systemic inflammatory syndrome * Severe peripheral vascular disease or significant carotid artery stenosis (\>50%) * Severe pulmonary disease or advanced respiratory failure * Implanted cardiac device (pacemaker/ICD) * Baseline mean arterial pressure (MAP) \<65 mmHg * Preoperative systolic blood pressure \>190 mmHg or diastolic blood pressure \>110 mmHg
Design outcomes
Primary
| Measure | Time frame | Description |
|---|---|---|
| Predictive performance of dynamic changes in carotid Doppler parameters (ΔVTI, ΔPSV, ΔFTc) for post-induction hypotension | From pre-induction passive leg raising assessment to 20 minutes after general anesthesia induction | Evaluation of the predictive performance of percentage changes in carotid artery velocity time integral (ΔVTI), peak systolic velocity (ΔPSV), and corrected flow time (ΔFTc) after passive leg raising maneuver for post-induction hypotension |
Secondary
| Measure | Time frame | Description |
|---|---|---|
| Association of baseline carotid Doppler parameters with post-induction hypotension | From pre-induction assessment to 20 minutes after general anesthesia induction | Evaluation of the association between baseline carotid Doppler parameters (VTI, PSV, and FTc) and the development of post-induction hypotension. |
| Cut-off values of changes in carotid Doppler parameters for prediction of post-induction hypotension | From pre-induction passive leg raising assessment to 20 minutes after general anesthesia induction | Determination of the optimal cut-off values of ΔVTI, ΔPSV, and ΔFTc for predicting post-induction hypotension. |
| Association of carotid Doppler changes with duration and severity of hypotension | From general anesthesia induction to 20 minutes post-induction | Evaluation of the association between ΔVTI, ΔPSV, and ΔFTc and the duration and severity of post-induction hypotension. |
| Association of carotid Doppler changes with vasopressor requirement | From general anesthesia induction to 20 minutes post-induction | Evaluation of the association between ΔVTI, ΔPSV, and ΔFTc and the requirement for vasopressor treatment after anesthesia induction. |
Countries
Turkey (Türkiye)
Contacts
CONTACTSeçilnaz Ünlü Tuncer, MD
Outcome results
None listed