PMID- 36299870 OWN - NLM STAT- PubMed-not-MEDLINE LR - 20230430 IS - 2297-055X (Print) IS - 2297-055X (Electronic) IS - 2297-055X (Linking) VI - 9 DP - 2022 TI - The effect of topical airway anesthesia on hemodynamic profiles during the induction period in patients undergoing cardiac surgery: Study protocol for a randomized controlled trial. PG - 992534 LID - 10.3389/fcvm.2022.992534 [doi] LID - 992534 AB - BACKGROUND: Patients scheduled for cardiac surgery are often accompanied by cardiac dysfunction and hemodynamic instability. However, the conventional induction strategy for anesthesia using high-dose intravenous anesthetics is often associated with persistent and recurrent hypotension after tracheal intubation. The purpose of this study is to investigate the effects of topical airway anesthesia on the hemodynamic profile of patients undergoing cardiac surgery during the induction period. METHODS: This is a superiority, single-blind, randomized controlled study with two parallel groups. Participants scheduled to undergo elective cardiac surgery will be allocated into two blocks according to the New York Heart Association (NYHA) classification and then randomly assigned to the following two groups at a 1:1 ratio: the conventional induction group and the combined topical airway anesthesia induction group. The combined topical airway anesthesia induction strategy includes aerosol inhalation airway anesthesia, subglottic airway anesthesia, and general anesthesia induction using low-dose intravenous anesthetics. The primary outcome is the area under the curve (AUC) of blood pressure below baseline mean arterial pressure (MAP) from 3 to 15 min after endotracheal intubation. Secondary outcomes include the AUC above baseline MAP and below baseline MAP at other time points, the highest and lowest arterial blood pressure values during the induction period, type and dose of vasoactive drugs, incidence of arrhythmias, cardiac function, and the incidence of postoperative hoarseness and sore throat. DISCUSSION: The study will explore whether aerosol inhalation airway anesthesia and subglottic airway anesthesia could reduce the incidence and duration of hypotension during the induction period in patients undergoing cardiac surgery. CLINICAL TRIAL REGISTRATION: This trial was registered on www.ClinicalTrials.gov (NCT05323786). CI - Copyright (c) 2022 Du, Lv, Chen, Sun, Wang, Zhang, Wei, Liu, Qiao and Wang. FAU - Du, Wenya AU - Du W AD - Department of Anesthesiology, The First Affiliated Hospital of Shandong First Medical University & Shandong Provincial Qianfoshan Hospital, Shandong Institute of Anesthesia and Respiratory Critical Care Medicine, Jinan, China. AD - Shandong First Medical University & Shandong Academy of Medical Sciences, Jinan, China. FAU - Lv, Meng AU - Lv M AD - Department of Anesthesiology, The First Affiliated Hospital of Shandong First Medical University & Shandong Provincial Qianfoshan Hospital, Shandong Institute of Anesthesia and Respiratory Critical Care Medicine, Jinan, China. AD - Shandong First Medical University & Shandong Academy of Medical Sciences, Jinan, China. FAU - Chen, Tingting AU - Chen T AD - Department of Anesthesiology, The First Affiliated Hospital of Shandong First Medical University & Shandong Provincial Qianfoshan Hospital, Shandong Institute of Anesthesia and Respiratory Critical Care Medicine, Jinan, China. AD - Shandong First Medical University & Shandong Academy of Medical Sciences, Jinan, China. FAU - Sun, Xiaxuan AU - Sun X AD - Department of Anesthesiology, The First Affiliated Hospital of Shandong First Medical University & Shandong Provincial Qianfoshan Hospital, Shandong Institute of Anesthesia and Respiratory Critical Care Medicine, Jinan, China. AD - Shandong First Medical University & Shandong Academy of Medical Sciences, Jinan, China. FAU - Wang, Jihua AU - Wang J AD - Department of Anesthesiology, The First Affiliated Hospital of Shandong First Medical University & Shandong Provincial Qianfoshan Hospital, Shandong Institute of Anesthesia and Respiratory Critical Care Medicine, Jinan, China. FAU - Zhang, Haixia AU - Zhang H AD - Department of Anesthesiology, The First Affiliated Hospital of Shandong First Medical University & Shandong Provincial Qianfoshan Hospital, Shandong Institute of Anesthesia and Respiratory Critical Care Medicine, Jinan, China. FAU - Wei, Chuansong AU - Wei C AD - Department of Anesthesiology, The First Affiliated Hospital of Shandong First Medical University & Shandong Provincial Qianfoshan Hospital, Shandong Institute of Anesthesia and Respiratory Critical Care Medicine, Jinan, China. FAU - Liu, Yi AU - Liu Y AD - Department of Anesthesiology, The First Affiliated Hospital of Shandong First Medical University & Shandong Provincial Qianfoshan Hospital, Shandong Institute of Anesthesia and Respiratory Critical Care Medicine, Jinan, China. FAU - Qiao, Changlong AU - Qiao C AD - Department of Anesthesiology, The First Affiliated Hospital of Shandong First Medical University & Shandong Provincial Qianfoshan Hospital, Shandong Institute of Anesthesia and Respiratory Critical Care Medicine, Jinan, China. FAU - Wang, Yuelan AU - Wang Y AD - Department of Anesthesiology, The First Affiliated Hospital of Shandong First Medical University & Shandong Provincial Qianfoshan Hospital, Shandong Institute of Anesthesia and Respiratory Critical Care Medicine, Jinan, China. AD - Shandong First Medical University & Shandong Academy of Medical Sciences, Jinan, China. LA - eng SI - ClinicalTrials.gov/NCT05323786 PT - Journal Article DEP - 20221010 PL - Switzerland TA - Front Cardiovasc Med JT - Frontiers in cardiovascular medicine JID - 101653388 EIN - Front Cardiovasc Med. 2023 Mar 31;10:1190323. PMID: 37063952 PMC - PMC9589145 OTO - NOTNLM OT - anesthesia induction OT - atomization inhalation OT - cardiac surgery OT - hemodynamics OT - topical airway anesthesia COIS- The authors declare that the research was conducted in the absence of any commercial or financial relationships that could be construed as a potential conflict of interest. EDAT- 2022/10/28 06:00 MHDA- 2022/10/28 06:01 PMCR- 2022/01/01 CRDT- 2022/10/27 02:37 PHST- 2022/07/12 00:00 [received] PHST- 2022/09/21 00:00 [accepted] PHST- 2022/10/27 02:37 [entrez] PHST- 2022/10/28 06:00 [pubmed] PHST- 2022/10/28 06:01 [medline] PHST- 2022/01/01 00:00 [pmc-release] AID - 10.3389/fcvm.2022.992534 [doi] PST - epublish SO - Front Cardiovasc Med. 2022 Oct 10;9:992534. doi: 10.3389/fcvm.2022.992534. eCollection 2022.