Using an ultrasound test to predict if blood pressure might drop after giving an injection in the back to block pain during caesarean section
- Conditions
- Other complications of spinal andepidural anesthesia during labor and delivery,
- Registration Number
- CTRI/2025/04/085644
- Brief Summary
Post spinal anaesthesia hypotension,PSAH, is a common clinical problem, occuring in upto 70 percentage of cases of caesarean section. PSAH can lead to severe maternal and fetal outcomes. Preanaesthetic identification of the fluid deficit may help prevent the critical decrease in blood pressure during operation. The inferior vena cava collapsibility index, IVCCI, has been used as a quantitative measure to assess the extent of IVC collapse and thus guide fluid therapy with an acceptable diagnostic reliability. Till date most of the studies for predicting PSAH by assessing the preoperative IVCCI through ultrasound guidance have been done in non obstetric population with very few such studies in obstetric population that too with patient in supine position. So we propose to conduct the study to know the role of IVCCI through ultrasound guidance in left lateral position to predict PSAH in pregnant women undergoing elective caesarean section. We hypothesis that IVCCI measured in left lateral position can predict PSAH in women undergoing elective caesarean section. The study will be started after obtaining approval from the Institute Ethics Committee and written and informed consent from the participants. On receiving patient at the Preoperative area pre anaesthetic records of the patients will be reviewed and height, weight, BMI of patient will be noted. Inferior Vena cava diameters will be measured using echocardiographic probe, 1to 5 MHz by M mode in sub xiphoid approach. IVCCI will be calculated by the following formula IVCCI is IVCd max minus IVCd min divided by IVCdmax multiplied by 100 where, IVCCI is the inferior venacava collapsibility index IVCd max is the maximum IVC diameter at end of expiration IVCd min is the minimum IVC diameter at end of inspiration. On receiving the patients in operating room, ASA standard monitors will be applied and baseline vital parameters will be recorded. Subarachnoid block will be administered with 2ml of hyperbaric bupivacaine 0.5 percentage. Thereafter heart rate ,systolic blood pressure, diastolic blood pressure and mean arterial pressure of patient will be recorded throughout the procedure at every 3 minutes interval for first 15 min of administration of spinal anaesthesia. Hypotension, defined as reduction in mean arterial pressure more than 20 percentage from the baseline and or MAP less than 65 mm Hg and bradycardia ,defined as heart rate less than 50 beats per minute will be recorded and treated according to standard institutional protocol.
- Detailed Description
Not available
Recruitment & Eligibility
- Status
- Not Yet Recruiting
- Sex
- Female
- Target Recruitment
- 90
Pregnant women aged 18 to 40 years Gestational age more than or equal to 37 weeks Singleton pregnancy American Society of Anaesthesiologists Physical Status I and II Undergoing elective caesarean section under spinal anaesthesia.
Refusal by patient Uncontrolled systemic comorbidities like diabetes hypertension Cardiovascular respiratory or renal impairment Patient in whom massive intraoperative blood loss is expected Hemoglobin less than 7 gram per decilitre Parturients who receive preloading of intravenous fluid.
Study & Design
- Study Type
- Observational
- Study Design
- Not specified
- Primary Outcome Measures
Name Time Method To study the role of inferior venecava collapsibility index in left lateral position to predict post spinal anaesthesia hypotension in women undergoing caesarean section Baseline, immediately after spinal anaesthesia ,3 minutes, 6 minutes, 9 minutes, 12 minutes, 15 minutes after spinal anaesthesia
- Secondary Outcome Measures
Name Time Method
Trial Locations
- Locations (1)
AIIMS RAIPUR
🇮🇳Raipur, CHHATTISGARH, India
AIIMS RAIPUR🇮🇳Raipur, CHHATTISGARH, IndiaDr Salva PPrincipal investigator8301000332Salvapalliyalil@gmail.com