Brachial Plexus Injury Clinical Trial
Official title:
Changes in Optic Nerve Sheath Diameter in Response to Various Levels of End Tidal Carbon Dioxide Levels in Healthy Patients Under General Anaesthesia
Intracranial Pressure ( ICP ) monitoring is an essential component of traumatic brain
injured ( TBI ) patients management. The clinical signs of raised ICP may be unreliable and
may reflect relatively late cerebral decompensation. ICP may be monitored by invasive or non
invasive techniques. While invasive techniques show the real time values of ICP, they are
associated with many complications like, intracranial bleeding and infection, occlusion of
the catheter tip by blood, debris and difficult to locate ventricle in presence of cerebral
oedema. All these drawbacks of invasive methods can be averted by employing non invasive
techniques of ICP monitoring. Although they do not show a real time value but are excellent
tools to detect presence or absence of raised ICP. Elevated ICP can be detected by
Computarised tomographic scan (CT) or Magnetic resonance imaging (MRI) but , these
techniques are time consuming and require transportation of a patients who may be unstable
.The quick and non invasive nature of ultrasonography is fast becoming popular for rapid
detection of elevated ICP at bedside in emergency and ICU by monitoring the optic nerve
sheath diameter ( ONSD ). Its limitations notwithstanding, ultrasonographic ONSD monitoring
is likely to be more reliable than clinical assessment in the diagnosis of intracranial
hypertension especially, when patient is under sedation which precludes proper clinical
examination. Therefore, in recent years ,among non invasive methods, bedside ocular
ultrasonography to monitor ICP has gained popularity.
Carbon dioxide being a potent modulator of cerebral vascular tone, alters the ICP by
changing the size of cerebral vasculature and thereby, cerebral blood flow (CBF) and this
action occurs very rapidly, over e period of few minutes. In a range of PaCO2 20mmHg to 80
mmHg the cerebral blood flow changes in a linear manner. End tidal carbon dioxide
concentration(EtCO2) is a surrogate measure of PaCO2 (especially in a haemodyanimically
stable patient with healthy lungs ) and is routinely monitored continuously in patients
subjected to general anaesthesia. To date there is very little literature on the effects
changing EtCO2 on ONSD . This prompted us to conduct this study to find out the effects of
different levels of EtCO2 on ONSD.
Status | Completed |
Enrollment | 30 |
Est. completion date | November 2016 |
Est. primary completion date | November 2016 |
Accepts healthy volunteers | Accepts Healthy Volunteers |
Gender | Both |
Age group | 18 Years to 65 Years |
Eligibility |
Inclusion Criteria: - ASA grade I adult patients in non head injury category between 18 to 65 years, of either gender undergoing brachial plexus injury surgery under general anesthesia. Exclusion Criteria: - Patients with a history of head injury, any respiratory or cardiovascular system disease or non consenting patients. |
Observational Model: Case-Crossover, Time Perspective: Prospective
Country | Name | City | State |
---|---|---|---|
India | Indu Kapoor | New Delhi | Delhi |
Lead Sponsor | Collaborator |
---|---|
All India Institute of Medical Sciences, New Delhi |
India,
Type | Measure | Description | Time frame | Safety issue |
---|---|---|---|---|
Primary | Change in Optic nerve sheath diameter [ONSD] measured by ultrasonography in response to change in End tidal Co2 concentration in patients with brachial plexus injury | 4 months | No |
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