At a glance
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Prospective Observational Study to Compare Hemodynamic Alterations in Severe Aortic Stenosis and Severe Mitral Regurgitation After High Spinal Anesthesia in Patients Undergoing Aortic Valve and Mitral Valve Replacement Surgery
In Brief
An observational study evaluating Cardiac valve replacement surgery under high spinal anesthesia combined with light general anesthesia for Severe Aortic Valve Stenosis and Severe Mitral Valve Regurgitation. Completed, enrolled 44 participants across 1 site.
Detailed Summary
This study will assess hemodynamic changes induced after spinal anesthesia by evaluating vasopressor inotropic requirements and variations in echocardiographic parameters in patients having severe aortic stenosis or severe mitral regurgitation undergoing aortic or mitral valve replacement surgery.
Study Details
Timeline
Interventions
Before induction of general anesthesia, a high spinal anesthesia will be given using 37.5 mg of 0.75% heavy bupivacaine with 20 mcg fentanyl and 250 mcg epimorphine in sitting position at the lumbar intervertebral spaces between the L2-3 or L3-4 vertebrae. Patients will lie supine immediately afterwards, and sensory loss to ice will be performed every 15 seconds. Subsequently, the patient will be placed in 15-degree Trendelenburg (ensured by clinometer). Following general anesthesia will be induced and trachea will be intubated after 5 ml of 4% lignocaine spray on vocal cords and trachea. Hemodynamics will be aimed at MAP between 65-100 mmHg and heart rate between 50-100 beats /min by use of various inotropic, inodilators and vasoactive cardiac drugs based on anesthesiologists' clinical judgement.