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Effect of Vasopressors on Spinal Anaesthesia Induced Hypotension

Phase 4
Completed
Conditions
Spinal Anesthesia
Interventions
Registration Number
NCT03163914
Lead Sponsor
Cukurova University
Brief Summary

160 pregnant patients will be enrolled in this study. Participants will divide in to 4 groups. Spinal anaesthesia will perform with 5% marcain heavy 2 ml+20 microgram fentanyl to the all patients. After performed spinal anaesthesia, vasopressor infusion will be started intravenously. Epinephrine will prepare 5 mg/ml and infusion rate will adjust 30 ml/h for Group E. Norepinephrine will prepare 5 mg/ml and infusion rate will adjust 30 ml/h for Group NE and 0.9% saline (group S) was launched immediately after induction of spinal anesthesia. Phenylephrine will prepare 100 microg/ml and infusion rate will adjust 30 ml/h for Group P. If systolic blood pressure decrease 20% of basal value or below to 100 mmHg, bolus ephedrine will apply intravenously (IV). If heart rate will decrease 60 beat per min or 20% of basal value, atropine will apply IV.

Detailed Description

After approved informed consent, 160 pregnant (term) patients with American society of anaesthesiologist (ASA) physiological status I-II will include this prospective, randomized clinical study. For randomisation of participants, computerized randomisation programme will use and they will divide into 4 groups. Basal value of systolic blood pressure(SBP) and heart rate (HR) will calculate with mean of the measure of 3 time SBP and HR before spinal anaesthesia. Spinal anaesthesia will perform with 5% marcain heavy 2 ml+20 microgram fentanyl at the point of lumbar 3-4 or 4-5 interspinous space to the all patients. After performed spinal anaesthesia, vasopressor infusion will start intravenously. Epinephrine, norepinephrine and phenylephrine will use for vasopressor infusion. Epinephrine will prepare 5 mg/ml and infusion rate will adjust 30 ml/h for Group E. Norepinephrine will prepare 5 mg/ml and infusion rate will adjust 30 ml/h for Group NE. Phenylephrine will prepare 100 microg/ml and infusion rate will adjust 30 ml/h for Group P. salin infusion will launch 30 ml/h for group Salin. If systolic blood pressure decrease 20% of basal value or below to 100 mmHg, bolus ephedrine will apply intravenously (IV) for rescue drug. If heart rate will decrease 60 beat per min or 20% of basal value, atropine will apply IV.

At the end of the study all collected data will use for statistically analysis.

Recruitment & Eligibility

Status
COMPLETED
Sex
Female
Target Recruitment
160
Inclusion Criteria
  • ASA I-II physical status
  • Pregnant patients
  • Full term pregnant
Exclusion Criteria
  • ASA III-IV physical status
  • Emergency status
  • Heart disease
  • Hypertension
  • Body mass index>25

Study & Design

Study Type
INTERVENTIONAL
Study Design
PARALLEL
Arm && Interventions
GroupInterventionDescription
ControlSalineSaline infusion will apply at equivalent volume till the surgical operation
EpinephrineEpinephrineEpinephrine will prepare as 5µg/ ml and epinephrine infusion rate will adjust 30 ml/h.
NorepinephrineNorepinephrineNorepinephrine will prepare as 5µg/ ml and epinephrine infusion rate will adjust 30 ml/h.
PhenylephrinePhenylephrinePhenylephrine will prepare as 100 µg/ ml and phenylephrine infusion rate will adjust 30 ml/h.
Primary Outcome Measures
NameTimeMethod
Incidence of intraoperative maternal hypotensionAt the time from start of vasopressor infusion till the end of surgery. The time frame is approximately 1 hour, peroperatively.

The incidence of hypotension (described as less than 80% of baseline (prenatal) SBP or SBP \<90 mm Hg), the total number of hypotension episodes during surgery

Secondary Outcome Measures
NameTimeMethod

Trial Locations

Locations (1)

Çukurova University Balcalı Hospital

🇹🇷

Adana, Turkey

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