Carotid Artery Corrected Flow Time as a Predictor of Hypotension After Induction of General Anesthesia in Elderly Patients

NCT05628051 | Completed

• 1 other identifier: 2022XHYG0018-01
• Study Type: observational
• Target: 177
• Locations: 1 country
• Sites: 1

Brief Summary

The number of elderly patients undergoing elective surgery has been growing in recent years. Elderly patients often have a variety of underlying diseases, including hypertension, coronary heart disease, diabetes, arteriosclerosis, etc., which increase the risk. When the elderly receive general anesthesia, hypotension often occurs after anesthesia induction. Once hypotension occurs, it may lead to myocardial ischemia, myocardial infarction, stroke and other serious complications. Therefore, in clinical anesthesia, a simple, quick and accurate prediction method is needed to evaluate and predict the risk of hypotension in elderly patients after induction, so that appropriate intervention measures can be taken in advance to reduce the incidence of hypotension in elderly patients after induction, thus reducing the occurrence of related complications and ensuring the safety of anesthesia and surgery.Carotid Artery Corrected Flow Time（FTc） is a recently developed volumetric predictor, which refers to the time between the the onset of systolic flow until the closure of the aortic valve. It is related to cardiac preload and can reflect cardiac output to a certain extent. It is considered as a reliable indicator for evaluating volume status and volumetric reactivity. Therefore, this study assessed the effect of FTc combined with perioperative fluid therapy on preventing hypotension after general anesthesia induction in elderly patients.

Conditions

General Anesthesia Induction for Elective Surgery

Outcome Measures

Primary Outcomes (1)

• Carotid artery corrected flow time (FTc)

  the area under the receiver operating characteristics curve of corrected flow time in carotid artery measured by ultrasonography to predict hypotension after anesthetic induction

  5 minutes before induction of general anesthesia

Study Arms (2)

Hypotension after anesthetic induction group

Patients with hypotension after anesthetic induction

Procedure: ultrasonographic measurement of carotid artery corrected flow time (FTc)

Non-hypotension after anesthetic induction group

Patients without hypotension after anesthetic induction

Procedure: ultrasonographic measurement of carotid artery corrected flow time (FTc)

Interventions

ultrasonographic measurement of carotid artery corrected flow time (FTc) PROCEDURE

Ultrasonic measurement of carotid corrected blood flow time: 1. Patient's head turned to the left 30°. Firstly, the 6.0 \~ 13.0MHz linear probe was placed longitudinally on the maternal neck, and the probe marker was oriented towards the maternal head. Real-time B-ultrasound images of the long axis of the right common carotid artery were obtained from the lower margin of the thyroid cartilage. Then, the probe was placed in the center of the carotid lumen, about 2cm from the bifurcation of the carotid artery, to obtain the arterial pulse Doppler flow spectrum and store the carotid flow waveform. 2. Using the caliper function of the ultrasonic instrument, carotid flow time (FT) was obtained by measuring the interval between the systolic ascending stage and the restroke notch. Wodey (W) formula to calculate FTc. FTc= FT+\[1.29× (HR-60)

Hypotension after anesthetic induction group; Non-hypotension after anesthetic induction group

Eligibility Criteria

• Age: 65 Years - 85 Years
• Sex: all
• Healthy Volunteers: No
• Age Groups: Older Adult (65+)
• Sampling Method: Non-Probability Sample

Study Population

Patients who were scheduled to undergo elective surgery under general anesthesia

You may qualify if:

• patients who received elective surgery under general anesthesia, aged 65-85 years old, gender unlimited, ASAI-II

You may not qualify if:

• uncontrolled hypertension
• unstable angina pectoris
• history of myocardial infarction
• after heart stent implantation
• severe arrhythmia：Atrial fibrillation、Ventricular premature beat, frequent atrial premature beat, other non-sinus rhythm
• pacemaker implants
• cardiomyopathy
• a left ventricular ejection fraction of \< 40%
• history of neck trauma and surgery
• BMI\>30

Sponsors & Collaborators

• Fujian Medical University Union Hospital: lead

Study Sites (1)

Fujian Medical University Union Hospital

Fuzhou, Fujian, 350001, China

Location

Related Publications (1)

• Huang S, Liao Z, Chen A, Wang J, Xu X, Zhang L. Effect of carotid corrected flow time combined with perioperative fluid therapy on preventing hypotension after general anesthesia induction in elderly patients: a prospective cohort study. Int J Surg. 2024 Feb 1;110(2):799-809. doi: 10.1097/JS9.0000000000000863.

  PMID: 37983823 DERIVED

Study Design

• Study Type: observational
• Observational Model: COHORT
• Time Perspective: PROSPECTIVE
• Sponsor Type: OTHER
• Responsible Party: SPONSOR

Study Record Dates

• First Submitted: November 17, 2022
• First Posted: November 28, 2022
• Study Start: June 1, 2022
• Primary Completion: December 30, 2022
• Study Completion: March 1, 2023
• Last Updated: November 1, 2023

Record last verified: 2023-10

Locations

CN (1)