Elderly patients undergoing elective non-cardiac surgery under general anesthesia Post-induction hypotension, elderly patients, non-cardiac surgery, positioning, leg elevation, head down, supine
Conditions
Interventions
The entire operating table will be tilted 30 degree head-down using a standard goniometer before induction of anesthesia,Place two standard pillows (30 cm) under the patient'
s legs while keeping the operating table in the neutral position before induction of anesthesia,keep operating table in the neutral position throughout the operation
Head down group,Leg elevation group,Supine group
Sponsors
Research Affairs, Faculty of Medicine, Khon Kaen university
Eligibility
Sex/Gender
All
Age
65 Years to No maximum
Inclusion criteria
Inclusion criteria: 1. Elderly patients (age > 65 years old) 2. ASA Class II-III 3. Scheduled for elective non-cardiac surgery under general anesthesia
Exclusion criteria
Exclusion criteria: 1. Patients refuse to participate 2. Patients with cardiac morbidities (impaired contractility with LVEF<50%, secondary-degree symptomatic Mobitz I, II or third-degree AV block, unstable arrhythmias, valvular heart disease, recent myocardial infarction less than 1 month before surgery) 3. Known allergy to study anesthetic drugs 4. Patients at increased risk of aspiration (inadequate fasting time, BMI > 40 kg/m2, GERD, Gut obstruction) 5. Raised intracranial/ocular pressure 6. Severe pulmonary disease (as indicated by a forced expiratory volume in 1 second (FEV1) of < 1.0 l) 7. Combination with neuraxial anesthesia 8. Recent unstable hemodynamic history
Design outcomes
Primary
| Measure | Time frame |
|---|---|
| Incidence of Post-induction hypotension At 1, 3, 5, 10 and 15 minutes after tracheal intubation OR until skin incision OR repositioning for surgery Blood pressure | — |
Secondary
| Measure | Time frame |
|---|---|
| Systolic blood pressure (SBP) At 1, 3, 5, 10 and 15 minutes after tracheal intubation OR until skin incision OR repositioning for surgery Blood pressure,Diastolic blood pressure (DBP) At 1, 3, 5, 10 and 15 minutes after tracheal intubation OR until skin incision OR repositioning for surgery Blood pressure,Mean arterial pressure (MAP) At 1, 3, 5, 10 and 15 minutes after tracheal intubation OR until skin incision OR repositioning for surgery Blood pressure,Heart rate (HR) At 1, 3, 5, 10 and 15 minutes after tracheal intubation OR until skin incision OR repositioning for surgery Heart rate (HR),Patients who required vasopressor administration After the induction of anesthesia Number of patients who required vasopressor administration,Total vasopressor consumption After the induction of anesthesia Total dose of vasopressor | — |
Countries
Thailand
Contacts
Public ContactSiwalai Sucher
Srinagarind hospital
Outcome results
None listed