Hypotension after spinal anesthesia
Conditions
Interventions
Gold Standard:Hypotension after spinal anesthesia is defined as a decrease in systolic blood pressure of greater than or equal to 25% or the minimum systolic blood pressure is less than or equal to 80
Index test:Corrected left ventricular-ejection time
Sponsors
Beijing Chao-Yang Hospital, Capital Medical University
Eligibility
Sex/Gender
Female
Age
18 Years to 40 Years
Inclusion criteria
Inclusion criteria: 1.Women aged 18 to 40 years. 2.Scheduled for elective caesarean section under combined spinal-epidural anesthesia. 3.ASA (American Society of Anesthesiologists) grade I-ll classification. 4.Singleton pregnancy with gestational age>36 weeks or <= 41 weeks. 5.Willingness to participate in this study and providing the informed consent.
Exclusion criteria
Exclusion criteria: 1.Poor impedance cardiogram (ICG) waveform caused by obvious interference (such as agitation, coughing, shivering, limb shaking). 2.Persistent high blood pressure after entering the operation room (systolic blood pressure>160 mmHg for noninvasive blood pressure after 5 minutes of rest in the operation room). 3.History of cardiovascular and cerebrovascular diseases. 4.Serious obstetric complications, including hypertensive disorders complicating pregnancy (gestational hypertension, preeclampsia, eclampsia, chronic hypertension with preeclampsia, chronic hypertension), placental abruption, pernicious placenta previa, placenta accreta. 5.Obesity (BMI>35kg/m^2) or emaciation (BMI<15 kg/m^2). 6.Contraindications to neuraxial anesthesia. 7.Skin rashes, infections, or ulcers at the site where the electrodes of the chest impedance monitoring device to be attached. 8.Severe aortic insufficiency. 9.Atrial septal defect or ventricular septal defect. 10.Severe aortic sclerosis or post-aortic repair surgery. 11.Aortic aneurysm or aortic dissection. 12.Status post-pacemaker implantation. 13.Height below 120cm or above 230cm. 14.Weight less than 30kg or more than 155kg. 15.History of allergies or other serious adverse reactions to the drugs used in the study. 16.History of allergies to medical tape, electrocardiogram electrodes, and medical skin surface dressings involved in this study.
Design outcomes
Primary
| Measure | Time frame |
|---|---|
| The area under the ROC curve and optimal threshold of corrected left ventricular-ejection time for predicting hypotension after spinal anesthesia in patients undergoing caesarean section; | — |
Secondary
| Measure | Time frame |
|---|---|
| Correlation between the preanesthetic corrected left ventricular-ejection time and the magnitude of decrease in SBP from the baseline;Incidence of hypotension after spinal anesthesia;Incidence of skin allergy with electrode of non-invasive hemodynamic detector;Patient satisfaction 24 hours after surgery;Changes in hemodynamics before and after spinal anesthesia; | — |
Countries
China
Contacts
Public ContactSai-Nan Wang
Beijing Chao-Yang Hospital, Capital Medical University
Outcome results
None listed