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Hemodynamic Effects of Lithotomy Position in Surgical Patients (PH-LITHO)
Sponsor: Trabzon Karadeniz Teknik Universitesi
Summary
Anesthesia-induced hypotension is a common occurrence in elderly hypertensive patients and is closely associated with increased postoperative morbidity * This study aims to investigate whether the lithotomy position, a non-pharmacological and cost-free approach, can reduce the incidence of post-induction hypotension (PIH) in this high-risk population by increasing venous return Sixty patients aged 65-80 with a history of hypertension were randomly assigned to either the Supine Group (Group S) or the Lithotomy Group (Group L) * In Group L, patients were placed in the lithotomy position 120 seconds before the start of anesthesia induction * Blood pressure was monitored every minute for the first five minutes following induction * The study evaluates whether this simple positioning strategy can maintain hemodynamic stability, reduce the drop in mean arterial pressure, and decrease the overall need for vasopressor medications like ephedrine
Official title: Does the Pre-induction Lithotomy Position Reduce Post-induction Hypotension in Geriatric Hypertensive Patients? A Prospective Randomized Study
Key Details
Gender
All
Age Range
65 Years - 80 Years
Study Type
INTERVENTIONAL
Enrollment
60
Start Date
2021-03-01
Completion Date
2022-01-31
Last Updated
2026-04-29
Healthy Volunteers
No
Interventions
Pre-induction Lithotomy Position
Patients are moved to the lithotomy position 120 seconds prior to the start of anesthesia induction to increase venous return * Following this 120-second interval in the lithotomy position, anesthesia is induced with intravenous midazolam (0.05 mg/kg), fentanyl (1 µg/kg), and thiopental (3-5 mg/kg) * All inductions are performed at a constant rate over 120 seconds * Post-induction hypotension (defined as MAP \< 65 mmHg or \>20% drop from baseline) is treated with 5 mg of intravenous ephedrine
Standard Supine Position
Patients remain in the standard supine position for a 3-minute rest period before induction begins * General anesthesia is induced using the same protocol as the experimental group: intravenous midazolam (0.05 mg/kg), fentanyl (1 µg/kg), and thiopental (3-5 mg/kg) administered over a period of 120 seconds * Hypotension (defined as MAP \< 65 mmHg or \>20% drop from baseline) is managed with 5 mg of intravenous ephedrine as rescue therapy
Locations (1)
Karadeniz Technical University Faculty of Medicine
Trabzon, Kalkınma, Turkey (Türkiye)