None listed
Conditions
Brief summary
The principal cardiovascular changes in pregnancy are increased sympathetic hyperactivity and systemic vascular resistance. Blood volume, heart rate, venous pressure in the lower extremity, and heart rate increase.In addition, peripheral resistance and pulmonary vascular resistance and blood pressure can be reduced. As the gestation week progresses It also affects the heart conduction system and makes patients more susceptible to arrhythmia. Regional anesthesia in cesarean surgeries has the advantages of allowing the mother to be awake during delivery and not neeeding airway manipulation, keeping mother’s airway reflexes, decreasing blood loss, reducing the risk of druginduced fetal depression, and carrying the need for analgesia over to the postoperative stage. But Neuroaxial blockade, such as spinal anesthesia, has been shown to modulate the effects of the stress response and sympathetic overactivity in pregnancy . The QT interval, a marker of ventricular repolarization is diagnosed when this value is more than 440 ms . A prolonged QT interval can cause serious cardiac rhythm problems such as ventricular tachydysrhythmias. Therefore, We aimed to investigate the effects of Spine Anesthesia on QT Dispersion in patients with different gestational weeks who were scheduled for elective cesarean section.
Interventions
patients will allocate to two group
Group 1: Equal and over 39th gestational age
Group 2: Under 39th gestational age
All patients will be monitored and the basal vital functions (HR, SpO2, NIBP, ECG ) will be recorded with admission into the OR. ECG monitorization will perform and their control ECG records was take.
All patients will placed into a sitting position and spinal anesthesia will be performed with a median approach at a level of L3-L4, with a 25 G Quincke type spinal needle and
patients will allocate to two group Group 1: Equal and over 39th gestational age Group 2: Under 39th gestational age All patients will be monitored and the basal vital functions (HR, SpO2, NIBP, ECG ) will be recorded with admission into the OR. ECG monitorization will perform and their control ECG records was take. All patients will placed into a sitting position and spinal anesthesia will be performed with a median approach at a level of L3-L4, with a 25 G Quincke type spinal needle and % 0.5 2.0 ml bupivacaine by anaesthesiologist. After succesful administration of anesthesia, all patients will be placed into supine position, monitored and administered oxygene via a venturi mask after administration of spinal anesthesia until the completion of surgery in %21 inspirated fraction. ECG records will take 1 , 5 , and 10 minutes after the block. Bromage scale (BS) scores, heart rate, blood pressure, peripheral oxygen saturation, respiration rate values and sensory block levels with pinprick test will record at minutes 1, 5 and 10 of spinal anesthesia and every 5 minutes thereafter after the end of surgery. end of surgery will record ECG. Standard 12 derivation ECG recordings obtained with a paper speed of 25 mm.sec-1 and a defl ection of 10 mm.mV-1 of patients participating in the study will analyze (Nihon Kohden cardiofaxm ). We will calculate heart rate using mean RR time. Spinal block levels, duration of surgery, APGAR scores, vasopressor consumption will be recorded.
Sponsors
Harran University School of Medicine, Research and Training Hospital
Study design
Allocation
Non-randomised trial
Intervention model
Parallel
Primary purpose
Treatment
Masking
Blinded (masking used) (Caregiver)
Eligibility
Sex/Gender
All
Age
18 Years to 45 Years
Healthy volunteers
Yes
Inclusion criteria
Forty pregnant women age between greater than or equal to 18 and less than or equal to 45, height greater than or equal to 1.60 cm, weight between greater than or equal to 60 and less than or equal to 100 kg, placed in the ASA risk group I-II in their preanesthetic evaluation and scheduled for elective cesarean surgery will included in the study.
Exclusion criteria
Exclusion criteria is refusal to participate in the study, the existence of brain tumors, scalded skin syndrome (SSS infection), spinal cord and peripheral nervous system diseases (poliomyelitis, multiple sclerosis, demyelinating diseases), hemorrhagic and hypovolemic shock, severe anemia, increased intracranial pressure, aortic and valvular heart disease, cardiac decompensation, systemic infection (generalized sepsis and bacteremia), local infection (dermal infections in puncture site of spinal needle, etc.), congenital spinal anomalies, scoliosis, post-traumatic vertebral injuries, vertebral colon metastatic lesions, increased abdominal pressure, chronic severe headache, anticoagulant drug use and anatomic diffi culties, electrolyte disturbances diabetes mellitus, hypothyroidism, hyperthyroidism, cardiomyopathy, atrial and/or ventricular hypertrophy on ECG, cardiomegaly, valvular disease, cardiac failure or chronic disease, patients with excessive smoking and alcohol consumption and used medication causing QT interval prolongation.
Outcome results
None listed