The investigators study 160 patients undergoing spinal surgery.Participants will be randomly divided into study group and control group.The study group will receive controlled hypotension by nitroglycerin and be divided into 3 groups according to CI.
This study will be done in Guangzhou Red Cross Hospital .The investigators study 160 patients aged from 45 to 70 years,weight from 48 to 68kg classified as American Society of Anesthesiologists (ASAs) physical status Ⅰ-Ⅱ who will be candidate for posterior decompression of vertebral canal,discectomy and internal fixation by pediclescrew(one centrum).The investigators excluded patients with cardiovascular and cerebrovascular diseases,hepatic or renal dysfunction,and patients receiving drugs that interfere with coagulation before surgery. Patients randomly divided into study group(group H,n=120)and control group (group C,n=40).The study group according to CI(Cardiac Index) levels of intraoperative hypotension period(mean of CI at T2,T3,T4) were divided into three groups: 1st group: CI: 1.5-2.0 L /(min•m2), 2nd group: CI: 2.0-3.0 L /(min•m2), 3rd group: CI: 3.0-4.0 L /(min•m2),and which CI \< 1.5 or CI \> 4.0 was eliminated the experimental group, which, in control group, CI\< 2.5 or CI \>4.0 was eliminated the experimental group.
Study Type
INTERVENTIONAL
Allocation
RANDOMIZED
Purpose
TREATMENT
Masking
SINGLE
Enrollment
160
The starting rate of "nitroglycerin" was 0.25 μg / kg / min and the mean arterial pressure (MAP) decreased to 80% of the baseline but not less than 70%.The drug infusion rate was adjusted so that the MAP was maintained in the range to the suture, and the administration was stopped and the blood pressure was gradually returned to the pre-depressurization level.
Guangzhou Red cross hospital
Guangzhou, Guangdong, China
RECRUITINGcardiac index(CI) after the participants are taken into the operating room
CI(L/min/m\^2)
Time frame: during surgery
cardiac index(CI) after the induction
cardiac index (CI,L/min/m\^2)
Time frame: during surgery
cardiac index(CI) at 5 minutes after tubation
cardiac index (CI,L/min/m\^2)
Time frame: 5 minutes after tubation
cardiac index(CI) at 10 minutes after tubation
cardiac index (CI,L/min/m\^2).
Time frame: 10 minutes after tubation
cardiac index(CI) at 15 minutes after tubation
cardiac index (CI,L/min/m\^2)
Time frame: 15 minutes after tubation
cardiac index(CI) at 30 minutes after tubation
cardiac index (CI,L/min/m\^2)
Time frame: 30 minutes after tubation
cardiac index(CI) at 45 minutes after tubation
cardiac index (CI,L/min/m\^2)
Time frame: 45 minutes after tubation
cardiac index(CI) at the end of surgery
cardiac index (CI,L/min/m\^2).
Time frame: at the end of surgery
cardiac index(CI) at 1 minute after extubation
cardiac index (CI,L/min/m\^2)
Time frame: 1 minute after extubation
Yang
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cardiac index(CI) at 5 minutes after extubation
cardiac index (CI,L/min/m\^2)
Time frame: 5 minutes after extubation
Partial pressure of oxygen after the participants are taken into the operating room
Partial pressure of oxygen (PaO2,mmHg)
Time frame: during surgery
Arterial oxygen saturation after the participants are taken into the operating room
Arterial oxygen saturation (SaO2,%)
Time frame: during surgery
Arterial blood hemoglobin after the participants are taken into the operating room
Arterial blood hemoglobin (Hb,g/L)
Time frame: during surgery
Arterial blood lactate after the participants are taken into the operating room
Arterial blood lactate (Lac,mmol/L)
Time frame: during surgery
Partial pressure central venous oxygen after the participants are taken into the operating room
Partial pressure central venous oxygen(PvO2,mmHg)
Time frame: during surgery
Central venous blood oxygen saturation after the participants are taken into the operating room
Central venous blood oxygen saturation(ScvO2,%)
Time frame: during surgery
Oxygen supply index after the participants are taken into the operating room
Oxygen supply index (DO2I,ml/min/m\^2)
Time frame: during surgery
Oxygen consumption index after the participants are taken into the operating room
Oxygen consumption index (VO2I,ml/min/m\^2)
Time frame: during surgery
Partial pressure of oxygen after the induction
Partial pressure of oxygen (PaO2,mmHg)
Time frame: during surgery
Arterial oxygen saturation after the induction
Arterial oxygen saturation (SaO2,%)
Time frame: during surgery
Arterial blood hemoglobin after the induction
Arterial blood hemoglobin (Hb,g/L)
Time frame: during surgery
Arterial blood lactate after the induction
Arterial blood lactate (Lac,mmol/L)
Time frame: during surgery
Partial pressure central venous oxygen after the induction
Partial pressure central venous oxygen(PvO2,mmHg)
Time frame: during surgery
Central venous blood oxygen saturation after the induction
Central venous blood oxygen saturation(ScvO2,%)
Time frame: during surgery
Oxygen supply index after the induction
Oxygen supply index (DO2I,ml/min/m\^2)
Time frame: during surgery
Oxygen consumption index after the induction
Oxygen consumption index (VO2I,ml/min/m\^2)
Time frame: during surgery
Partial pressure of oxygen at 5 minutes after tubation
Partial pressure of oxygen (PaO2,mmHg)
Time frame: 5 minutes after tubation
Arterial oxygen saturation at 5 minutes after tubation
Arterial oxygen saturation (SaO2,%)
Time frame: 5 minutes after tubation
Arterial blood hemoglobin at 5 minutes after tubation
Arterial blood hemoglobin (Hb,g/L)
Time frame: 5 minutes after tubation
Arterial blood lactate at 5 minutes after tubation
Arterial blood lactate (Lac,mmol/L)
Time frame: 5 minutes after tubation
Partial pressure central venous oxygen at 5 minutes after tubation
Partial pressure central venous oxygen(PvO2,mmHg)
Time frame: 5 minutes after tubation
Central venous blood oxygen saturation at 5 minutes after tubation
Central venous blood oxygen saturation(ScvO2,%)
Time frame: 5 minutes after tubation
Oxygen supply index at 5 minutes after tubation
Oxygen supply index (DO2I,ml/min/m\^2)
Time frame: 5 minutes after tubation
Oxygen consumption index at 5 minutes after tubation
Oxygen consumption index (VO2I,ml/min/m\^2)
Time frame: 5 minutes after tubation
Partial pressure of oxygen at 10 minutes after tubation
Partial pressure of oxygen (PaO2,mmHg)
Time frame: 10 minutes after tubation
Arterial oxygen saturation at 10 minutes after tubation
Arterial oxygen saturation (SaO2,%)
Time frame: 10 minutes after tubation
Arterial blood hemoglobin at 10 minutes after tubation
Arterial blood hemoglobin (Hb,g/L)
Time frame: 10 minutes after tubation
Arterial blood lactate at 10 minutes after tubation
Arterial blood lactate (Lac,mmol/L)
Time frame: 10 minutes after tubation
Partial pressure central venous oxygen at 10 minutes after tubation
Partial pressure central venous oxygen(PvO2,mmHg)
Time frame: 10 minutes after tubation
Central venous blood oxygen saturation at 10 minutes after tubation
Central venous blood oxygen saturation(ScvO2,%)
Time frame: 10 minutes after tubation
Oxygen supply index at 10 minutes after tubation
Oxygen supply index (DO2I,ml/min/m\^2)
Time frame: 10 minutes after tubation
Oxygen consumption index at 10 minutes after tubation
Oxygen consumption index (VO2I,ml/min/m\^2)
Time frame: 10 minutes after tubation
Partial pressure of oxygen at 15 minutes after tubation
Partial pressure of oxygen (PaO2,mmHg)
Time frame: 15 minutes after tubation
Arterial oxygen saturation at 15 minutes after tubation
Arterial oxygen saturation (SaO2,%)
Time frame: 15 minutes after tubation
Arterial blood hemoglobin at 15 minutes after tubation
Arterial blood hemoglobin (Hb,g/L)
Time frame: 15 minutes after tubation
Arterial blood lactate at 15 minutes after tubation
Arterial blood lactate (Lac,mmol/L)
Time frame: 15 minutes after tubation
Partial pressure central venous oxygen at 15 minutes after tubation
Partial pressure central venous oxygen(PvO2,mmHg)
Time frame: 15 minutes after tubation
Central venous blood oxygen saturation at 15 minutes after tubation
Central venous blood oxygen saturation(ScvO2,%)
Time frame: 15 minutes after tubation
Oxygen supply index at 15 minutes after tubation
Oxygen supply index (DO2I,ml/min/m\^2)
Time frame: 15 minutes after tubation
Calculated index at 15 minutes after tubation
Oxygen consumption index (VO2I,ml/min/m\^2)
Time frame: 15 minutes after tubation
Partial pressure of oxygen at 30 minutes after tubation
Partial pressure of oxygen (PaO2,mmHg)
Time frame: 30 minutes after tubation
Arterial oxygen saturation at 30 minutes after tubation
Arterial oxygen saturation (SaO2,%)
Time frame: 30 minutes after tubation
Arterial blood hemoglobin at 30 minutes after tubation
Arterial blood hemoglobin (Hb,g/L)
Time frame: 30 minutes after tubation
Arterial blood lactate at 30 minutes after tubation
Arterial blood lactate (Lac,mmol/L)
Time frame: 30 minutes after tubation
Partial pressure central venous oxygen at 30 minutes after tubation
Partial pressure central venous oxygen(PvO2,mmHg)
Time frame: 30 minutes after tubation
Central venous blood oxygen saturation at 30 minutes after tubation
Central venous blood oxygen saturation(ScvO2,%)
Time frame: 30 minutes after tubation
Oxygen supply index at 30 minutes after tubation
Oxygen supply index (DO2I,ml/min/m\^2)
Time frame: 30 minutes after tubation
Oxygen consumption index at 30 minutes after tubation
Oxygen consumption index (VO2I,ml/min/m\^2)
Time frame: 30 minutes after tubation
Partial pressure of oxygen at 45 minutes after tubation
Partial pressure of oxygen (PaO2,mmHg)
Time frame: 45 minutes after tubation
Arterial oxygen saturation at 45 minutes after tubation
Arterial oxygen saturation (SaO2,%)
Time frame: 45 minutes after tubation
Arterial blood hemoglobin at 45 minutes after tubation
Arterial blood hemoglobin (Hb,g/L)
Time frame: 45 minutes after tubation
Partial pressure central venous oxygen at 45 minutes after tubation
Partial pressure central venous oxygen(PvO2,mmHg)
Time frame: 45 minutes after tubation
Arterial blood lactate at 45 minutes after tubation
Arterial blood lactate (Lac,mmol/L)
Time frame: 45 minutes after tubation
Oxygen supply index at 45 minutes after tubation
Oxygen supply index (DO2I,ml/min/m\^2)
Time frame: 45 minutes after tubation
Oxygen consumption index at 45 minutes after tubation
Oxygen consumption index (VO2I,ml/min/m\^2)
Time frame: 45 minutes after tubation
Central venous blood oxygen saturation at 45 minutes after tubation
Central venous blood oxygen saturation(ScvO2,%)
Time frame: 45 minutes after tubation
Partial pressure of oxygen at the end of surgery
Partial pressure of oxygen (PaO2,mmHg)
Time frame: at the end of surgery
Arterial oxygen saturation at the end of surgery
Arterial oxygen saturation (SaO2,%)
Time frame: at the end of surgery
Arterial blood hemoglobin at the end of surgery
Arterial blood hemoglobin (Hb,g/L)
Time frame: at the end of surgery
Arterial blood lactate at the end of surgery
Arterial blood lactate (Lac,mmol/L)
Time frame: at the end of surgery
Partial pressure central venous oxygen at the end of surgery
Partial pressure central venous oxygen(PvO2,mmHg)
Time frame: at the end of surgery
Central venous blood oxygen saturation at the end of surgery
Central venous blood oxygen saturation(ScvO2,%)
Time frame: at the end of surgery
Oxygen supply index at the end of surgery
Oxygen supply index (DO2I,ml/min/m\^2)
Time frame: at the end of surgery
Oxygen consumption index at the end of surgery
Oxygen consumption index (VO2I,ml/min/m\^2)
Time frame: at the end of surgery
Partial pressure of oxygen at 1 minute after extubation
Partial pressure of oxygen (PaO2,mmHg)
Time frame: 1 minute after extubation
Arterial oxygen saturation at 1 minute after extubation
Arterial oxygen saturation (SaO2,%)
Time frame: 1 minute after extubation
Arterial blood hemoglobin at 1 minute after extubation
Arterial blood hemoglobin (Hb,g/L)
Time frame: 1 minute after extubation
Arterial blood lactate at 1 minute after extubation
Arterial blood lactate (Lac,mmol/L)
Time frame: 1 minute after extubation
Partial pressure central venous oxygen at 1 minute after extubation
Partial pressure central venous oxygen(PvO2,mmHg)
Time frame: 1 minute after extubation
Central venous blood oxygen saturation at 1 minute after extubation
Central venous blood oxygen saturation(ScvO2,%)
Time frame: 1 minute after extubation
Oxygen supply index at 1 minute after extubation
Oxygen supply index (DO2I,ml/min/m\^2)
Time frame: 1 minute after extubation
Oxygen consumption index at 1 minute after extubation
Oxygen consumption index (VO2I,ml/min/m\^2)
Time frame: 1 minute after extubation
Plartia pressure of oxygen at 5 minutes after extubation
Plartia pressure of oxygen (PaO2,mmHg)
Time frame: 5 minutes after extubation
Arterial oxygen saturation at 5 minutes after extubation
Arterial oxygen saturation (SaO2,%)
Time frame: 5 minutes after extubation
Arterial blood hemoglobin at 5 minutes after extubation
Arterial blood hemoglobin (Hb,g/L)
Time frame: 5 minutes after extubation
Arterial blood lactate at 5 minutes after extubation
Arterial blood lactate (Lac,mmol/L)
Time frame: 5 minutes after extubation
Partial pressure central venous oxygen at 5 minutes after extubation
Partial pressure central venous oxnyge(PvO2,mmHg)
Time frame: 5 minutes after extubation
Central venous blood oxygen saturation at 5 minutes after extubation
Central venous blood oxygen saturation(ScvO2,%)
Time frame: 5 minutes after extubation
Oxygen supply index at 5 minutes after extubation
Oxygen supply index (DO2I,ml/min/m\^2)
Time frame: 5 minutes after extubation
Oxygen consumption index at 5 minutes after extubation
Oxygen consumption index (VO2I,ml/min/m\^2).
Time frame: 5 minutes after extubation
mean artery pressure(MAP) after the participants are taken into the operatin after the participantsg room
MAP(mmHg)
Time frame: during surgery
heart rate(HR) after the participants are taken into the operating room
HR(beat per minute)
Time frame: during surgery
central venous pressure(CVP) after the participants are taken into the operating room
CVP(mmHg)
Time frame: during surgery
variability of stroke volume(SVV) after the participants are taken into the operating room
SVV (%)
Time frame: during surgery
mean artery pressure(MAP) after the induction
MAP(mmHg)
Time frame: during surgery
heart rate(HR) after the induction
HR(heart rate,beat per minute)
Time frame: during surgery
central venous pressure(CVP) after the induction
CVP(mmHg)
Time frame: during surgery
variability of stroke volume(SVV) after the induction
SVV (variability of stroke volume,%)
Time frame: during surgery
mean artery pressure(MAP) at 5 minutes after tubation
MAP(mmHg)m\^2)
Time frame: 5 minutes after tubation
heart rate(HR) at 5 minutes after tubation
HR(heart rate,beat per minute),
Time frame: 5 minutes after tubation
central venous pressure(CVP) at 5 minutes after tubation
CVP(mmHg)
Time frame: 5 minutes after tubation
variability of stroke volume(SVV) at 5 minutes after tubation
SVV (variability of stroke volume,%)
Time frame: 5 minutes after tubation
mean artery pressure(MAP) at 10 minutes after tubation
MAP(mmHg)
Time frame: 10 minutes after tubation
heart rate(HR) at 10 minutes after tubation
HR(heart rate,beat per minute)
Time frame: 10 minutes after tubation
central venous pressure(CVP) at 10 minutes after tubation
CVP(mmHg)
Time frame: 10 minutes after tubation
variability of stroke volume(SVV) at 10 minutes after tubation
SVV (variability of stroke volume,%)
Time frame: 10 minutes after tubation
mean artery pressure(MAP) at 15 minutes after tubation
MAP(mmHg)
Time frame: 15 minutes after tubation
heart rate(HR) at 15 minutes after tubation
HR(heart rate,beat per minute)
Time frame: 15 minutes after tubation
central venous pressure(CVP) at 15 minutes after tubation
CVP(mmHg)
Time frame: 15 minutes after tubation
variability of stroke volume(SVV) at 15 minutes after tubation
SVV (variability of stroke volume,%)
Time frame: 15 minutes after tubation
mean artery pressure(MAP) at 30 minutes after tubation
MAP(mmHg)
Time frame: 30 minutes after tubation
heart rate(HR) at 30 minutes after tubation
HR(heart rate,beat per minute)
Time frame: 30 minutes after tubation
central venous pressure(CVP) at 30 minutes after tubation
CVP(mmHg)
Time frame: 30 minutes after tubation
variability of stroke volume(SVV) at 30 minutes after tubation
SVV (variability of stroke volume,%)
Time frame: 30 minutes after tubation
mean artery pressure(MAP) at 45 minutes after tubation
MAP(mmHg)
Time frame: 45 minutes after tubation
heart rate(HR) at 45 minutes after tubation
HR(heart rate,beat per minute)
Time frame: 45 minutes after tubation
central venous pressure(CVP) at 45 minutes after tubation
CVP(mmHg)
Time frame: 45 minutes after tubation
variability of stroke volume(SVV) at 45 minutes after tubation
SVV (variability of stroke volume,%)
Time frame: 45 minutes after tubation
mean artery pressure(MAP) at the end of surgery
MAP(mmHg)
Time frame: at the end of surgery
central venous pressure(CVP) at the end of surgery
CVP(mmHg)
Time frame: at the end of surgery
variability of stroke volume(SVV) at the end of surgery
SVV (variability of stroke volume,%)
Time frame: at the end of surgery
heart rate(HR) at the end of surgery
HR(heart rate,beat per minute)
Time frame: at the end of surgery
mean artery pressure(MAP) at 1 minute after extubation
MAP(mmHg)
Time frame: 1 minute after extubation
heart rate(HR) at 1 minute after extubation
HR(heart rate,beat per minute)
Time frame: 1 minute after extubation
variability of stroke volume(SVV) at 1 minute after extubation
SVV (variability of stroke volume,%)
Time frame: 1 minute after extubation
central venous pressure(CVP) at 1 minute after extubation
CVP(mmHg)
Time frame: 1 minute after extubation
mean artery pressure(MAP) at 5 minutes after extubation
MAP(mmHg)
Time frame: 5 minutes after extubation
central venous pressure(CVP) at 5 minutes after extubation
CVP(mmHg)
Time frame: 5 minutes after extubation
heart rate(HR) at 5 minutes after extubation
HR(heart rate,beat per minute)
Time frame: 5 minutes after extubation
variability of stroke volume(SVV) at 5 minutes after extubation
SVV (variability of stroke volume,%)
Time frame: 5 minutes after extubation