Jugular Venous Flow Neurosurgical Patients

Jugular Venous Flow Clinical Trial

Official title:

Effect of Different Surgical Positions on the Cerebral Venous Drainage: an Ultrasound Study on Neurosurgical Patients

Clinical Trial Details — Status: Withdrawn

Administrative data

• NCT number: NCT02002507
• Other study ID #: 13-6432
• Status: Withdrawn
• Start date: January 2015
• Est. completion date: December 31, 2019

Study information

• Verified date: December 2022
• Source: University Health Network, Toronto
• Contact: n/a
• Is FDA regulated: No
• Study type: Observational

Clinical Trial Summary

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 between the right and left internal jugular veins in the park bench position. In particular, 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 positions.

Description:

The different positions used in neurosurgery for better accessibility to the operating field (park bench, prone) can impact cerebral venous drainage due to the effects of internal jugular venous outflow of blood, and may increase intracranial pressure. Excessive neck flexion and rotation in the park bench position, or flexion in the prone position, may lead to kinking or twisting of the internal jugular vein. This has been hypothesized as the major cause of disturbed venous drainage during surgery and may lead to neck swelling, brachial plexus injury, macroglossia (swollen tongue), delayed airway obstruction, and increases in intracranial pressure in postoperative patients. Optimal brain perfusion is best in the neutral position of the head, but surgery cannot always be performed in this position. Thus, we look to measure the internal jugular venous flow at different positions, as there have been few studies looking at this important contributing factor.

Recruitment information / eligibility

• Status: Withdrawn
• Enrollment: 0
• Est. completion date: December 31, 2019
• Est. primary completion date: November 21, 2019
• Accepts healthy volunteers: No
• Gender: All
• Age group: 18 Years and older

Eligibility

Inclusion Criteria:

• Adult neurosurgical patients who are above the age of 18

• Patients undergoing neurosurgery requiring general anesthesia and placement in either in prone or park bench position for surgical accessibility

Exclusion Criteria:

• Lack of informed consent

• Patients undergoing surgical procedures only in the supine position

• Patients needing a central venous catheter in the neck

Related Conditions & MeSH terms

• Jugular Venous Flow

Intervention

Other:
• comparison of different neurosurgical position
in 2 of 3 positions (supine, plus either prone or park bench) with both left and right internal jugular vein cross-sectional area of vein, doppler velocity, internal jugular venous flow, position of internal jugular vein in relation to carotid artery (All measured with the use of ultrasound)

Locations

Country	Name	City	State
Canada	University Health Network, Toronto Western Hospital	Toronto	Ontario

Sponsors (1)

Lead Sponsor	Collaborator
University Health Network, Toronto

Country where clinical trial is conducted

Canada, 

Outcome

Type	Measure	Description	Time frame	Safety issue
Primary	Jugular venous flow	One of the following will be compared depending on the position of the patient; Bilateral internal jugular venous flow in supine and prone position; Bilateral internal jugular venous flow in supine and park bench position	1 day
Secondary	cross- sectional area of internal jugular vein	Comparing the cross-sectional area of the internal jugular vein in different positions	1 day
Secondary	doppler velocity of jugular venous flow	Comparing the doppler velocity of jugular venous flow in different surgical positions in neurosurgical patients	1 day