Physiology-Guided Airway Preparation Enhances Hemodynamics and Cerebral Oxygenation

N/AEnrolling By InvitationNCT07526077

Prince Sultan Military Medical City90 enrolled

Overview

This study looked at a safer way to prepare patients for anesthesia before major spinal surgery. Instead of using advanced or complex oxygen devices, the approach used standard oxygen methods, guided by the patient's individual physiological responses (such as oxygen levels and circulation).

We proposed that a physiology-guided airway preparation approach, relying solely on conventional oxygen delivery methods, would enhance haemodynamic stability and cerebral oxygenation during anaesthetic induction in patients undergoing major spinal surgery. The findings are intended to improve patient safety, support better intraoperative decision-making, and potentially encourage wider integration of cerebral oximetry into perioperative neuroprotection strategies.

Study Type

OBSERVATIONAL

Enrollment

Conditions

Airway Reactivity Hemodynamic Stability During Anesthesia

Interventions

regional cerebral oxygen saturationPROCEDURE

By employing multi-wavelength technology on the forehead, the O3 device provides clinicians with crucial insights into the balance between cerebral oxygen demand and supply. This monitoring is especially valuable for high-risk patient populations, such as those undergoing cardiac surgery, and patients in the intensive care unit (ICU), which provides a continuous, non-invasive assessment of rSO₂ enabling the prompt detection of critical desaturation events. Crucially, changes in rSO₂ during induction correlate with factors directly relevant to spinal cord safety, such as hypotension, hypocapnia, and reduced cardiac output.

Eligibility

Sex: ALLMin age: 18 YearsMax age: 70 Years

Medical Language ↔ Plain English

Inclusion Criteria: * Major spinal surgery * Under general anesthesia Exclusion Criteria: * Left ventricular ejection fraction \< 35% * Known intracranial pathology * Severe pulmonary disease * Body mass index \>40 kg•m-² * Emergency surgery * Planned awake intubation * Known autonomic dysfunction

Locations (1)

Prince Sultan Military Medical City

Riyadh, Saudi Arabia

Outcomes

Primary Outcomes

MAP variability during induction

Maximum percentage decrease in MAP from baseline between induction and intubation

Time frame: MAP will be recorded non-invasively at four specific time points: 1 Baseline (before airway preparation) 2 Immediately before intubation 3 Immediately after intubation 4 Five minutes after intubation

Secondary Outcomes

Incidence of cerebral oxygen desaturation

≥20% decrease in rSO₂ from baseline

Time frame: During endotracheal intubation

Data from ClinicalTrials.gov

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