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Effect of Intraoperative Position Change on Hemodynamics and Electrocardiography

NCT06835166 · Status: COMPLETED · Type: OBSERVATIONAL · Enrollment: 80

Last updated 2026-01-16

No results posted yet for this study

Summary

The combined effects of obesity-related cardiac structure and function changes, comorbidities, pneumoperitoneum technique, and reverse Trendelenburg position may complicate anesthesia management by affecting intraoperative hemodynamics and cardiac function. Increased intra-abdominal pressure leads to various physiological changes through mechanical and neurohormonal responses. Furthermore, pneumoperitoneum and reverse Trendelenburg position are reported to stimulate the sympathetic nervous system and increase the risk of cardiac arrhythmia.

Obesity-related changes in cardiac structure and function have been shown to predispose to cardiac conduction and repolarization disorders. It has also been stated that obesity directly affects cardiac electrophysiology.

Moreover, obese patients may have hidden risks associated with the development of cardiac arrhythmias due to the adverse contributions of the cardiovascular effects of anesthesia, pneumoperitoneum, and patient positioning during laparoscopic intervention.

The index of cardiac electrophysiological balance (iCEB) is a non-invasive marker calculated by the QT/QRS ratio that can predict malignant ventricular arrhythmias.

The aim of this study was to investigate the effects of intraoperative patient positions on hemodynamics and the index of cardiac electrophysiological balance (iCEB) during laparoscopic sleeve gastrectomy in morbidly obese patients.

Conditions

  • Bariatric Surgery (Sleeve Gastrectomy )
  • Hemodynamics
  • Electrocardiography

Interventions

PROCEDURE

12-lead electrocardiography measurement

Intraoperative 12-lead electrocardiography (EKG) measurement during laparoscopic sleeve gastrectomy in morbidly obese patients: In all patients, pneumoperitoneum CO₂ intraabdominal pressure will be studied as 15 cmH₂O. Intraoperatively, 12-lead ECG will be obtained at five position measurement points: Procedure1. Supine-monitored; Procedure 2. After induction; Procedure 3. Under general anesthesia-Supine-abdominal inflated; Procedure 4. Abdominal inflated-(30% vertical) Reverse Trendelenburg; Procedure 5. Abdominal deflated-(30% vertical) Reverse Trendelenburg. Hemodynamic monitoring \[systolic blood pressure, diastolic blood pressure, mean arterial pressure, heart rate \] was recorded at 5 simultaneous measurement points. All hemodynamic measurements and ECG recordings will be performed 3 minutes after the position change to ensure standardization, to allow the response to settle after the position change, and to prevent the possibility of exaggerated-incorrect data.

Sponsors & Collaborators

  • Firat University

    lead OTHER

Principal Investigators

Eligibility

Min Age
18 Years
Max Age
65 Years
Sex
ALL
Healthy Volunteers
No

Timeline & Regulatory

Start
2025-02-10
Primary Completion
2025-04-25
Completion
2025-05-20

Countries

  • Turkey (Türkiye)

Study Locations

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Read the full study record

This page highlights key information. For complete eligibility criteria, study locations, investigator contacts, and the full protocol, visit the original record on ClinicalTrials.gov.

View NCT06835166 on ClinicalTrials.gov