Effect of Carotid Ultrasound-guided Fluid Management on Anesthetic-induced Hypotension in Elderly Patients Undergoing Gastrointestinal Surgery

N/AUnknownNCT05891951

Min Su150 enrolled

Overview

The goal of this clinical trial is to learn about Whether carotid ultrasound guided fluid management can reduce the incidence of hypotension after general anesthesia induction in elderly patients undergoing gastrointestinal surgery. The main question\[s\] it aims to answer are: Whether fluid therapy reduces the incidence of general anaesthesia induced hypotension in elderly patients undergoing gastrointestinal surgery. Whether carotid ultrasound can guide fluid management in elderly patients undergoing gastrointestinal surgery. Participants will use carotid ultrasound to assess volume status. If volume is insufficient, fluid therapy will be selected until volume is sufficient, anesthesia will be then induced. If volume is sufficient, anesthesia will be directly induced. There is a comparison group: No carotid ultrasound will be used to assess the volume status of the patients, and anesthesia will be directly induced.

Study Type

INTERVENTIONAL

Allocation

RANDOMIZED

Purpose

PREVENTION

Masking

SINGLE

Enrollment

150

Conditions

Hypotension on Induction

Interventions

Eligibility

Sex: ALLMin age: 60 YearsMax age: 80 YearsHealthy volunteers:

Medical Language ↔ Plain English

Inclusion Criteria: * Age 60-80 years old * gender unlimited * ASA: Grade I-Ⅲ * BMI:18-30kg/㎡ * Patients undergoing elective gastrointestinal surgery under general anesthesia Informed consent Exclusion Criteria: * Carotid artery stenosis ≥50% * Patients with heart valve disease * Patients with left ventricular ejection fraction \< 50% * Patients with cardiac dysfunction (NYHA grade Ⅲ-Ⅳ and/or NTproBNP≥900pg/ml) * Patients Combined with renal insufficiency (creatinine ≥178μmol/L, and/or blood urea nitrogen \> 9mmol/L) * Preoperative systolic blood pressure\> 160mmHg or diastolic blood pressure \> 100mmHg * Refuse to participate in the test * Patients participating in other clinical trials

Outcomes

Primary Outcomes

Occurrence of hypotension after anesthesia induction

Hypotension occurred from anesthesia induction to 20 minutes after induction in both groups.

Time frame: General anesthesia induction from the beginning to 20 minutes after induction

Secondary Outcomes

Postoperative acute kidney injury

Postoperative creatinine increased for a short period of time to more than 0.3mg/dl (26.5μmol/L) or to more than 1.5 times the preoperative creatinine concentration.

Time frame: Within 7 days after surgery

postoperative delirium

Newly diagnosed delirium by the psychiatric department within 30 days after surgery

Time frame: Within 30 days after surgery

postoperative stroke

Any newly diagnosed postoperative neurological dysfunction within 30 days after surgery.