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Brachial non-invasive blood pressure (NIBP) monitoring is recommended as part of the American Society of Anesthesiology (ASA) basic monitoring package. Although brachial NIBP is often practical, some surgeries and patients may require NIBP measurement elsewhere (e.g. the ankle).
Several studies have shown that ankle NIBP overestimates brachial NIBP measurements. Algorithms have been proposed, based on correlation studies, to estimate brachial NIBP from ankle NIBP during general anesthesia and mechanical ventilation. These algorithms, however, are based on both heterogeneous populations and surgeries.
Our aim was to determine if ankle brachial NIBP difference occurs in in young ASA physical status 1 patients undergoing general anesthesia in the supine position. We also aim to determine if this difference is constant during anesthesia or if it varies according to different predefined time points.
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| Label | Type | Description | Intervention Names |
|---|---|---|---|
| General anesthesia | Patient (15 to 40 years old) undergoing elective surgery requiring general anesthesia in supine position. |
|
| Name | Type | Description | Arm Group Labels | Other Names |
|---|---|---|---|---|
| Ankle Non-invasive Blood pressure measurement | Device | Non-invasive blood pressure measured simultaneously at the arm (model IntelliVue M8105a MP5 Phillips, calibrated). |
|
| Measure | Description | Time Frame |
|---|---|---|
| Ankle Brachial non-invasive blood pressure difference - time point 1 | Difference between the non-invasive blood pressure measured at the ankle and at the arm, before induction of anesthesia | 1 day |
| Ankle Brachial non-invasive blood pressure difference - time point 2 | Difference between the non-invasive blood pressure measured at the ankle and at the arm, after induction of anesthesia | 1 day |
| Ankle Brachial non-invasive blood pressure difference - time point 3 | Difference between the non-invasive blood pressure measured at the ankle and at the arm, after securing airway | 1 day |
| Ankle Brachial non-invasive blood pressure difference - time point 4 | Difference between the non-invasive blood pressure measured at the ankle and at the arm, at surgical incision | 1 day |
| Ankle Brachial non-invasive blood pressure difference - time point 5 | Difference between the non-invasive blood pressure measured at the ankle and at the arm, 10 minutes after surgical incision | 1 day |
| Ankle Brachial non-invasive blood pressure difference - time point 6 | Difference between the non-invasive blood pressure measured at the ankle and at the arm, at reversal of anesthesia | 1 day |
| Measure | Description | Time Frame |
|---|---|---|
| Pain at the arm (yes/no) | Answer 'yes' or 'no' to the question 'pain at the arm' in postoperative period | 1 day |
| Pain at the ankle (yes/no) | Answer 'yes' or 'no' to the question 'pain at the ankle' in postoperative period |
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Inclusion Criteria:
Exclusion Criteria:
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Patient undergoing elective surgery requiring general anesthesia in supine position. American Society of Anesthesiology (ASA) pysical status score 1.
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| Name | Affiliation | Role |
|---|---|---|
| Sean Coeckelenbergh, MD | CHU Brugmann | Principal Investigator |
| Facility | Status | City | State | ZIP | Country | Contacts |
|---|---|---|---|---|---|---|
| CHU Brugmann | Brussels | 1020 | Belgium |
| PubMed Identifier | Type | Citation | Retractions |
|---|---|---|---|
| 15558917 | Background | Wilkes JM, DiPalma JA. Brachial blood pressure monitoring versus ankle monitoring during colonoscopy. South Med J. 2004 Oct;97(10):939-41. doi: 10.1097/01.SMJ.0000129929.28792.77. | |
| 23480469 | Background | Drake MJ, Hill JS. Observational study comparing non-invasive blood pressure measurement at the arm and ankle during caesarean section. Anaesthesia. 2013 May;68(5):461-6. doi: 10.1111/anae.12194. Epub 2013 Mar 11. |
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| Arm Non-invasive Blood pressure measurement | Device | Non-invasive blood pressure measured simultaneously at the ankle (model IntelliVue M8105a MP5 Phillips, calibrated). |
|
| 1 day |
| Ankle Brachial NIBP difference variation | Determine if Ankle Brachial NIBP difference remains constant or varies during different intraoperative periods | 1 day |
| 23159553 | Background | Aboyans V, Criqui MH, Abraham P, Allison MA, Creager MA, Diehm C, Fowkes FG, Hiatt WR, Jonsson B, Lacroix P, Marin B, McDermott MM, Norgren L, Pande RL, Preux PM, Stoffers HE, Treat-Jacobson D; American Heart Association Council on Peripheral Vascular Disease; Council on Epidemiology and Prevention; Council on Clinical Cardiology; Council on Cardiovascular Nursing; Council on Cardiovascular Radiology and Intervention, and Council on Cardiovascular Surgery and Anesthesia. Measurement and interpretation of the ankle-brachial index: a scientific statement from the American Heart Association. Circulation. 2012 Dec 11;126(24):2890-909. doi: 10.1161/CIR.0b013e318276fbcb. Epub 2012 Nov 16. No abstract available. |