Postoperative Orthostatic Intolerance and Hypotension in Unilateral TKA
Açar sözlər
Mücərrəd
Təsvir
Early postoperative mobilization is a cornerstone in the so-called fast track multimodal perioperative approach and is essential in preventing postoperative morbidity and reducing hospital length-of-stay. Intact orthostatic blood pressure regulation is essential for early postoperative mobilization. However, early postoperative mobilization can be delayed due to postoperative orthostatic hypotension (POH) defined as a fall in systolic pressure > 20 mmHg and/or diastolic pressure > 10 mmHg or due to postoperative orthostatic intolerance (POI), characterized by dizziness, nausea, vomiting, blurred vision or syncope during mobilization.
Previous prospective studies of major surgery have reported that OI and OH are common problem during early postoperative mobilization, with a prevalence of 42-50%. Retrospective studies with a less-defined mobilization protocols have reported am OI prevalence in the range of 12-60 % across surgical procedures.
The aim of our study is to determine the incidence of OI during early postoperative mobilization in fast track unilateral total knee arthroplasty.
Tarixlər
| Son Doğrulandı: | 12/31/2019 |
| İlk təqdim: | 11/07/2018 |
| Təxmini qeydiyyat təqdim edildi: | 11/13/2018 |
| İlk Göndərmə: | 11/14/2018 |
| Son Yeniləmə Göndərildi: | 01/08/2020 |
| Son Yeniləmə Göndərildi: | 01/12/2020 |
| Həqiqi Təhsilin Başlama Tarixi: | 11/12/2018 |
| Təxmini İlkin Tamamlanma Tarixi: | 06/30/2019 |
| Təxmini İşin Tamamlanma Tarixi: | 02/29/2020 |
Vəziyyət və ya xəstəlik
Faza
Qol Qrupları
| Qol | Müdaxilə / müalicə |
|---|---|
| Orthostatic intolerant (OI) Patients that experience symptoms of orthostatic intolerance (dizziness, nausea, vomiting, blurry vision or syncope) or orthostatic hypotension (fall in systolic pressure > 20 mmHg and/or diastolic pressure > 10 mmHg) during mobilisation | |
| Orthostatic tolerant (OT) Patients that do not experience symptoms of orthostatic intolerance (dizziness, nausea, vomiting, blurry vision or syncope) or orthostatic hypotension (fall in systolic pressure > 20 mmHg and/or diastolic pressure > 10 mmHg) during mobilisation |
Uyğunluq Kriteriyaları
| Təhsil üçün uyğun yaşlar | 18 Years Üçün 18 Years |
| Təhsilə Uyğun Cinslər | All |
| Nümunə götürmə metodu | Probability Sample |
| Sağlam Könüllüləri qəbul edir | Bəli |
| Kriteriyalar | Inclusion Criteria: - Age ≥ 18 - Written informed consent - Patients that speak and understand Danish - Patients undergoing primary unilateral total knee arthroplasty in spinal anesthesia and standardized fast-track setting Exclusion Criteria: - Alcohol or drug abuse - Cognitive dysfunction - Known orthostatic hypotension - Use of anxiolytic drugs |
Nəticə
İlkin nəticə tədbirləri
1. Incidence of orthostatic intolerance [6 hours postoperatively]
2. Incidence of orthostatic hypotension [6 hours postoperatively]
İkincili Nəticə Tədbirləri
1. Changes in systolic arterial pressure (SAP) during mobilization [Preoperatively, 6 and 24 hours postoperatively]
2. Changes in diastolic arterial pressure (DAP) during mobilization [Preoperatively, 6 and 24 hours postoperatively]
3. Changes in mean arterial pressure (MAP) during mobilization [Preoperatively, 6 and 24 hours postoperatively]
4. Changes in systemic vascular resistance (SVR) during mobilization [Preoperatively, 6 and 24 hours postoperatively]
5. Changes in cardiac output (CO) during mobilization [Preoperatively, 6 and 24 hours postoperatively]
6. Changes in stroke volume (SV) during mobilization [Preoperatively, 6 and 24 hours postoperatively]
