Prediction of Spinal Anesthesia-Induced Hypotension in Cesarian Section: Carotid Artery-Corrected Flow Time Versus Cardiometry: Randomized Controlled Trial
Overview
- Phase
- N/A
- Intervention
- Not specified
- Conditions
- Spinal Anesthesia
- Sponsor
- Tanta University
- Enrollment
- 300
- Locations
- 1
- Primary Endpoint
- The incidence of post-spinal hypotension
- Status
- Completed
- Last Updated
- 2 years ago
Overview
Brief Summary
This research aimed to evaluate and compare the role of carotid corrected flow time (FTc) and electrical cardiometry (EC) in the prediction and prevention of post-spinal hypotension in elective cesarian section.
Detailed Description
Spinal anesthesia is the procedure of choice for elective cesarean section (CS) because it avoids the most common side effects related to general anesthesia, such as the risk of aspiration, airway problems and the negative effects of intravenous anesthetic drugs on the fetus. Accurate prediction of post-spinal hypotension could enhance clinical decision-making, optimize management, and facilitate early intervention. More than thirty predictors were used in the prediction of post-spinal hypotension including demographic data, hemodynamic variables, postural stress testing, peripheral perfusion indices, volume and fluid responsiveness indices, and genetic polymorphism. The baseline parameters obtained via the bioreactance-based system may serve as a predictor of post-spinal anesthesia hypotension in parturient.
Investigators
Mostafa Mahmoud Shehab
Assistant Lecturer of Anesthesiology, Surgical Intensive Care and Pain Medicine
Tanta University
Eligibility Criteria
Inclusion Criteria
- •Aged ≥ 18 years.
- •American Society of Anesthesiologists (ASA) physical status II.
- •Gestational age (GA) ≥ 36 weeks.
- •Women planned elective cesarean section under spinal anesthesia.
Exclusion Criteria
- •Patient refusal to participate in the study.
- •Gestational age of \< 36 or ≥40 weeks of pregnancy.
- •Pregnancy-induced hypertension.
- •Diabetes.
- •Cardiovascular diseases, arrhythmia.
- •Antepartum hemorrhage.
- •Body Mass Index (BMI) above 36 kg/m
- •Clinical fetal complications.
Outcomes
Primary Outcomes
The incidence of post-spinal hypotension
Time Frame: Intraoperatively
Incidence of spinal anesthesia-induced hypotension was measured. Post spinal hypotension is defined as a drop in the SBP to less than 80mmHg, or less than 75% of the pre-anesthetic value. Hypotension was treated by IV vasopressor boluses (Ephedrine 5 mg).
Secondary Outcomes
- Complications(Intraoperatively)
- The amount of vasopressor(Intraoperatively)
- The amount of intravenous fluids(Intraoperatively)
- Umbilical cord PH(Immediately after fetal delivery)
- Neonatal APGAR score(5 minutes after fetal delivery)