Effect of Different Types of Anesthesia on Perioperative Brain Natriuretic Peptide Levels in Parturient Cardiac Patient Undergoing Elective Cesarean Section

Completed

• Conditions: General Anesthesia Versus Spinal Anesthesia on BNP Hormone Levels Preoperatively and Postoperatively in Parturient Cardiac Patient Undergoing C.S

• Registration Number: NCT03460184
• Lead Sponsor: Cairo University

Brief Summary

comparing the effect of general anesthesia versus spinal anesthesia on brain natruretic peptide hormone levels preoperatively and postoperatively in parturient cardiac patient undergoing cesarean section

Detailed Description

In our study, investigators will detect changes in brain natruretic peptide (BNP) levels in parturient patients at risk undergoing cesarean section, in relation to type of anesthesia used, general anesthesia versus spinal anesthesia, in order to evaluate the safety of type of anesthesia used for this kind of patient.

It is very important to assess and predict risk in the cardiovascular system in such cases. A number of cardiac indexes for predicting risk have been developed like Goldman Multifactorial risk index, Eagle's risk index and Detsky's cardiac index. It is recommended to evaluate patients using these indexes and to institute preoperative medical treatment based on the results. These clinical scoring systems, although simple to use, are somewhat inconvenient and have limitations in their predictive value, whereas other cardiac investigations such as exercise or pharmacologic stress imaging are sensitive, but limited in practice by time and resources. Recently brain natriuretic peptide (BNP) was spotlighted as a predictor for diagnosing and predicting the prognosis of various heart diseases. BNP is a cardiac hormone that is synthesized by ventricular myocytes in response to ventricular dysfunction. Recent studies have demonstrated that elevated serum BNP levels predict first cardiovascular event and death in the general population. In addition, it has been reported that BNP measured before major surgery can be used as a predictor of postoperative cardiac complications.

Study Timeline

• Study Start: 2018-02-18
• Study First Submitted: 2018-03-04
• Study First Submitted QC: 2018-03-04
• Study First Posted: 2018-03-09
• Primary Completion: 2018-06-05
• Study Completion: 2018-06-10
• Status Verified: 2020-06
• Last Update Submitted: 2020-06-13
• Last Update Posted: 2020-06-16

Recruitment & Eligibility

• Status: COMPLETED
• Sex: Female
• Target Recruitment: 60

Inclusion Criteria

• Mild to moderate valvular heart lesions.
• Cardiomyopathic lesions with ejection fraction > 40%
• Ischemic heart disease
• Hypertension
• Non-fatal arrhythmias eg. Controlled AF

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Exclusion Criteria

Cardiomyopathic lesions with EF less than 40% Tight stenotic lesions Severe regurgitant lesions Pregnancy induced hypertension Fatal arrhythmia eg. Ventricular tachycardia renal impairment Cr > 1.2 surgery related problems: operation longer than 3 hours patient resuscitation with > 3 litres blood loss more than 1 liter

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Study & Design

• Study Type: OBSERVATIONAL
• Study Design: Not specified

Primary Outcome Measures

Name	Time	Method
Monitoring changes in BNP	24 hours postoperative	Monitoring changes in BNP level pre and postoperatively in relation to type of anesthesia to evaluate the safety of type of anesthesia used in cesarean section for parturient with cardiac diseas

Secondary Outcome Measures

Name	Time	Method
Efficiency of BNP	24 hours postoperative	Efficiency of BNP in detection of cardiac complications
Hemodynamic monitoring	24 hours postoperative	Monitor changes in hemodynamics in relation to type of anesthesiaM

Trial Locations

Locations (1)

Cairo University; 🇪🇬 Cairo, Egypt