Jugular Venous Blood Flow Clinical Trial
Official title:
Effect of Different Surgical Positions on the Cerebral Venous Drainage: an Ultrasound Study on Healthy Volunteers
Our hypothesis is that there will be a decrease in internal jugular venous flow in the park bench position when compared to the supine position. There will also be a change in blood flow in the between right and left internal jugular veins in park bench position, particularly there will be a greater reduction of flow on the dependent side. However, the internal jugular venous flow will be the same in both the prone and supine position.
The different positions used in neurosurgery (park bench, prone) for better accessibility to
the operating field can impact on the cerebral venous drainage due to the effects of internal
jugular venous outflow of blood and may increase intracranial pressure. The kinking of the
internal jugular vein due to excessive neck flexion and rotation in park bench or flexion in
the prone position may lead to kinking or twisting of the vein. This has been hypothesized as
the major cause of disturbed venous drainage during surgery and in postoperative patients may
lead to neck swelling, brachial plexus injury, macroglossia (swollen tongue), delayed airway
obstruction and increases in intracranial pressure.
Optimal brain perfusion is best in the neutral position of the head, but surgery cannot
always be performed with this. Thus, we look to measure the internal jugular venous flow at
different positions as there have been little studies looking at this important contributing
factor.
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