Autonomic Modulation After Spinal Anesthesia With Depth of Anesthesia and Vital Signs.

National Central University

Status: Completed

Conditions: Participants Scheduled for Surgery Under Spinal Anesthesia Without Impairment of Renal, Hepatic, Cardiac or Respiratory Function

Treatments: Other: observation study about the autonomic response after spinal anesthesia

Study type: Observational

Funder types: Other

Identifiers

NCT04275375

2019-01-016CC

Details and patient eligibility

About

Spinal anaesthesia has the advantage that produced nerve block by the injection of local anaesthetic into cerebrospinal fluid (CSF). However, the greatest challenge in spinal anaesthesia is to control the spread of local anaesthetic through the CSF to provide a block which is adequate for the proposed surgery without unnecessary extensive spread, and increased risk of complications.

Full description

The activity of the autonomic nervous system is of fundamental importance in the regulation of vital bodily functions. Unbalance of autonomic nerve system results in considerably disordered vital function. Clinically, this is of great significance, because if an anesthetic agent produces cause the sympathetic system to block, the effects can be serious in individual cases, particularly on the cardiovascular system. If complications are to be avoided, it is essential to assess the degree of block correctly. Clinical monitoring has a variety of applications, a particularly useful one being measurement of the sympathetic system during regional anesthesia, for which quantification of the blocking effect is a clinical necessity and the degree of block needs to be ascertained without delay. The autonomic nervous system (ANS) plays an important role in the regulation of hemodynamics during anesthesia. Analysis of beat-to-beat fluctuations of heart rate and blood pressure is a promising new approach to the clinical diagnosis and management of alterations in cardiovascular regulation. Continuous Wavelet Transform (CWT), which could overcome the limitation of the steady-state assumption in the classical spectral analysis, is believed as a reliable and robust method to access cardiorespiratory dynamics of the ANS and the investigators will applied during spinal anesthesia to evaluate the detail changes.

Enrollment: 46 patients

Sex: All

Ages: 20 to 80 years old

Volunteers: No Healthy Volunteers

Inclusion criteria

1. patients scheduled for operation with spinal anesthesia

Exclusion criteria

1. recently treat with a sedative, beta-blocker, parasympatholytic, or opioid agent
2. emergency surgery
3. hypovolemia and hypothermia, arrhythmia, diabetes, or impairment of renal, hepatic, coagulation, cardiac, or respiratory function

Trial design

46 participants in 2 patient groups

hyperbaric bupivacaine

Description:

The dosage of hyperbaric bupivacaine decided by the clinical anesthesiologist. This study is an observational study.

Treatment:

Other: observation study about the autonomic response after spinal anesthesia

plain bupivacaine

Description:

The dosage of plain bupivacaine decided by the clinical anesthesiologist. This study is an observational study.

Treatment:

Other: observation study about the autonomic response after spinal anesthesia