Hemodynamic Impact of Epidural Anesthesia in Relation to Age in Pediatric

Status Recruiting

Clinical Trial Summary

Epidural analgesia is established as the gold standard in the management of post-surgical pain in multiple modalities, including the pediatric patient. It is a technique that is not without risks, but with multiple benefits such as less response to stress, less incidence of chronic pain after surgery, less incidence of nausea and vomiting and other adverse effects derived from opioids, faster recovery and increased patient and family satisfaction. However, as it has been mentioned, the epidural carries risks both in the technique itself (wet or intravascular puncture) and subsequently after the injection of medication that generates a sympathetic blockade with arterial hypotension and an increase in compensatory heart rate. Unlike in adult patients, in pediatric patients epidural and subarachnoid anesthesia are better tolerated hemodynamically due to less vagal and sympathetic activity and almost no systemic venodilation. This lower activity of the autonomic nervous system is due to its immaturity, which is why, with the growth of the infant, this anesthetic technique increasingly affects its hemodynamics, being similar to the adult at the age of 8-12 years. The study hypothesis does not differ from that stated in physiology books and studies, but the investigators seek to identify the direct correlation of age with the different hemodynamic parameters available with current technology (cardiac output, systemic vascular resistance, blood pressure ) in pediatric patients after epidural anesthesia. The study will be carried out in pediatric patients undergoing major surgery that requires the placement of an epidural catheter and invasive blood pressure, without modifying in any way the usual practice of the responsible anesthesiologist. The patient's hemodynamic data will be collected at time 0 (prior to catheter placement), one minute, 5 and 10 minutes after the bolus of local anesthetic administered to measure the child's hemodynamic response and relate it to their age and development. .

Clinical Trial Description

Through this work the investigators seek to establish statistically and numerically a hypothesis affirmed in physiology books. In this way, if it is found a positive correlation with age and hypotension, the responsible physician can be alerted to the need for possible vasoconstrictor requirements or more advanced monitoring in order to reduce intraoperative risks. ;

Study Design

Related Conditions & MeSH terms

Clinical Trial Details

NCT number	NCT05543824
Study type	Observational
Source	Hospital Universitario La Fe
Contact
Status	Recruiting
Phase
Start date	September 12, 2022
Completion date	September 10, 2023

View Details

See also
Status	Clinical Trial	Phase
Completed	`NCT02823392` - Difficult Bag Mask Ventilation and Difficult Intubation in Children
Recruiting	`NCT05358535` - Propofol and Etomidate Admixtures Comparisons Trial (PEAC Trial)	Phase 3
Recruiting	`NCT03839784` - Building a Platform for Precision Anesthesia in the Geriatric Surgical Patient
Completed	`NCT04087668` - Different Anesthetic Technique For ERCP	N/A
Recruiting	`NCT03109119` - Does Sevoflurane Cause Genomic Damage	Phase 4
Recruiting	`NCT04604106` - General Anesthesia Exposure and Neurodevelopmental Outcome in Pediatrics
Enrolling by invitation	`NCT04322994` - THRIVE Use in Pediatric Populations- Multi Site	N/A
Not yet recruiting	`NCT06015074` - Ciprofol vs Propofol for Reducing Hypoxia Incidence in ERCP	N/A
Completed	`NCT05383417` - No Post Intubation Laryngeal Symptoms	N/A
Completed	`NCT03394833` - Hemodynamic Stability During Induction of Anaesthesia	N/A
Active, not recruiting	`NCT06382961` - Postoperative Dexmedetomidine in Prevention of Postoperative Delirium	N/A
Completed	`NCT05368415` - Comparison Between Three Norepinephrine Bolus Doses for Management of Post-spinal Hypotension During Ceaserian Section for Patients With Preeclampsia	Phase 4
Completed	`NCT04284644` - Co-induction Technique Compared to Standard Inhalational and Intravenous Induction Techniques	N/A
Completed	`NCT03833947` - Dexamethasone vs Bicarbonate to Intracuff Lignocaine 2% in General Anaesthesia	Phase 4
Not yet recruiting	`NCT06324955` - Language During Inhalational Induction	N/A
Not yet recruiting	`NCT05737407` - Lung Ultrasound Guided Choice of Best Positive End-Expiratory Pressure in Neonatal Anesthesia	N/A
Active, not recruiting	`NCT04275531` - Neurotoxicity of Anesthesia in Middle Aged Patients
Completed	`NCT05868642` - Impatto Emodinamico Dell'Anestesia Subaracnoidea Titrata Versus Tecnica Single-shot Nei Pazienti Sottoposti ad Artroprotesi d'Anca. RCT	N/A
Not yet recruiting	`NCT05869578` - Registry of Anesthesia and Perioperative Medicine
Completed	`NCT04455776` - Safety Evaluation of Propofol Sedation for Magnetic Resonance Imaging in Pediatric Patients

Clinical trials are conducted in a series of steps, called phases - each phase is designed to answer a separate research question.

Phase 1: Researchers test a new drug or treatment in a small group of people for the first time to evaluate its safety, determine a safe dosage range, and identify side effects.
Phase 2: The drug or treatment is given to a larger group of people to see if it is effective and to further evaluate its safety.
Phase 3: The drug or treatment is given to large groups of people to confirm its effectiveness, monitor side effects, compare it to commonly used treatments, and collect information that will allow the drug or treatment to be used safely.
Phase 4: Studies are done after the drug or treatment has been marketed to gather information on the drug's effect in various populations and any side effects associated with long-term use.

Hemodynamic Impact of Epidural Anesthesia in Relation to Age in Pediatric Patients. — REHAEPP-2022

Clinical Trial Summary

Clinical Trial Description

Study Design

Related Conditions & MeSH terms