Orthopedic Surgery Clinical Trial
Official title:
Cardiac Output Changes During Onset of Spinal Anesthesia in Elderly Patients
The purpose of this study was to evaluate the changes in heart function during onset of spinal anesthesia using a new and less invasive method, the LidcoTMplus.
The incidence of hypotension during onset of spinal anesthesia in elderly patients varies
from 27% to 80% depending on which definition being used. Studies of cardiac output (CO) has
shown that it is maintained or only slightly decreased .
Unfortunately, the time-resolution in these studies is often several minutes, and the
description of changes is consequently often a start-to-end relation rather than a
description of the dynamic changes during onset of spinal anesthesia.
A recent advance in measuring CO is the LiDCOTMplus hemodynamic monitor, which has proved
reliable compared to pulmonary artery catheters in various intensive care settings. This
monitor allows for beat-to-beat measuring during various procedures and thus early warning
of hemodynamic events.
Another method with potential for early warning of decreased perfusion is near-infrared
spectroscopy (NIRS). NIRS is used for continuous and non-invasive monitoring of cerebral
oxygen saturation (ScO2) and even a small reduction has recently shown to predict maternal
hypotension during caesarian section.
The aim of our study was to describe the changes in CO during onset of spinal anesthesia in
elderly patients using a method with high time-resolution. We also attempted to evaluate
NIRS as predictor of hemodynamic events.
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Observational Model: Defined Population, Time Perspective: Cross-Sectional
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