Patient undergoing general anesthesia in elective surgery will be assigned to receive either methohexital or propofol general anesthesia. Hypotensive events during the first 15 minutes of induction will be compared between the groups to ascertain which drug is less likely to cause a hypotensive event.
Patients taking angiotensin converting-enzyme inhibitors (ACEIs) or angiotensin receptor blockers (ARBs) are susceptible to hypotensive events during general anesthesia. The purpose of this study is to determine if the use of either methohexital or propofol general anesthesias is more likely to result in hypotensive events in these patients during their induction. Hemodynamic metrics like blood pressure, mean arterial pressure, and heart rate will be monitored during the induction process, under both drugs, for use as the main metrics, as well as the need for vasopressors in response to patient hypotension.
Study Type
INTERVENTIONAL
Allocation
RANDOMIZED
Purpose
TREATMENT
Masking
NONE
Enrollment
51
Both drugs of interest are standard of care for use as general anesthetics. The purpose of the study is the determine the susceptibility of both drugs to inducing a hypotensive event.
Both drugs of interest are standard of care for use as general anesthetics. The purpose of the study is the determine the susceptibility of both drugs to inducing a hypotensive event.
Penn State Milton S Hershey Medical Ctr
Hershey, Pennsylvania, United States
Number of Participants Who Had Hypotensive Events
Hypotensive events under either methohexital or propofol general anesthesia will be counted as the primary outcome measure
Time frame: Hemodynamic measurements will be taken during the first 15 minutes of anesthetic induction
Number of Participants With Refractory Hypotension
Refractory hypotension is defined as a hypotensive event that continues after 3 doses of vasopressors
Time frame: Hemodynamic measurements will be taken during the first 15 minutes of anesthetic induction
Duration of Each Hypotension Episode
This is the length of time that systolic blood pressure was either: (1) \< 85 mmHg, or (2) a decrease of more than 30% from the individual's baseline SBP.
Time frame: Hemodynamic measurements will be taken during the first 15 minutes of anesthetic induction
Systolic Blood Pressure
Systolic blood pressure will be measured through standard monitoring.
Time frame: Hemodynamic measurements will be taken during the first 15 minutes of anesthetic induction
Diastolic Blood Pressure
Diastolic blood pressure will be measured through standard monitoring.
Time frame: Hemodynamic measurements will be taken during the first 15 minutes of anesthetic induction
Heart Rate
Heart rate will be measured through standard monitoring.
Time frame: Hemodynamic measurements will be taken during the first 15 minutes of anesthetic induction
Serum Concentration of Norepinephrine (NE) (at Baseline (Time 0) and 3,5,10 and 15 Min After Anesthetic Induction)
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Serum concentrations of NE at predetermined time points (Baseline (Time 0) and 3,5,10 and 15 min) following anesthetic induction
Time frame: Time 0,3,5,10 and 15 min following anesthetic induction
Blood Levels of Epinephrine (at Baseline (Time 0) and 3,5,10 and 15 Min After Induction of Anesthesia)
Serum concentrations of Epinephrine at predetermined time points (Baseline (Time 0) and 3,5,10 and 15 min) following anesthetic induction
Time frame: Time 0,3,5,10 and 15 min following anesthetic induction
Blood Levels of Angiotensin II (AII) (at Baseline (Time 0) and 3,5,10 and 15 Min After Anesthetic Induction)
Serum concentrations of Angiotension II at predetermined time points (Baseline (Time 0) and 3,5,10 and 15 min) following anesthetic induction
Time frame: Time 0,3,5,10 and 15 min following anesthetic induction
Blood Levels of Arginine Vasopressin (AVP) (at Baseline (Time 0) and 3,5,10 and 15 Min After Anesthetic Induction) for Participants Who Did Not Receive AVP for Refractory Hypotension
Serum concentrations of AVP at predetermined time points (Baseline (Time 0) and 3,5,10 and 15 min) following anesthetic induction determined for participants who did not receive AVP for refractory hypotension
Time frame: Time 0,3,5,10 and 15 min following anesthetic induction
Blood Levels of AVP (at Baseline (Time 0) and 3,5,10 and 15 Min) for Participants Who Received AVP for Refractory Hypotension
Serum concentrations of AVP at predetermined time points (Baseline (Time 0) and 3,5,10 and 15 min), following anesthetic induction, determined for Participants who did not receive AVP for refractory hypotension
Time frame: Time 0,3,5,10 and 15 min following anesthetic induction