Cesarean Section
Conditions
Keywords
Combined epidural spinal anesthesia, Fluid therapy
Brief summary
Regional anesthesia, including epidural, spinal and combined epidural spinal anesthesia (CSEA), is a pivotal part in modern anesthesiology. Previously, the investigators found that epidural and spinal anesthesia during cesarean section possesses different responsiveness to fluid (including crystalloid and colloid) management given prior or posterior to anesthesia. Although CSEA is also widely used as an alternative of single epidural or spinal anesthesia for its combined effect of fast onset of anesthesia of spinal anesthesia and the property of duration of epidural catheterization, the fluid resuscitation during CSEA is still unknown. The investigators hypothesized that fluid management during CSEA would produce different effect on hemodynamics in cesarean section compared with epidural and spinal anesthesia.
Interventions
DRUGRinger's Lactate
Ringer's Lactate 8 ml/kg was given intravenously before or after CSEA in cesarean section
Hydroxyethyl starch (6%) was given before or after CSEA in cesarean section
Sponsors
Nanjing Medical University
Study design
Allocation
RANDOMIZED
Intervention model
PARALLEL
Primary purpose
SUPPORTIVE_CARE
Masking
NONE
Eligibility
Sex/Gender
FEMALE
Age
21 Years to 40 Years
Healthy volunteers
No
Inclusion criteria
* 21-40 yr * First time of delivery * ASA status I-II * No premature * No genetic and infectious diseases * Chinese
Exclusion criteria
* \< 21 yr * \> 40 yr * Subjects with cardiac and pulmonary disorders * Dislocation of placenta * Pregnant hypertension * Allergy to local anesthetics * Unwilling to cooperation * Need intraoperative administration of vascular active agents * With significant delivery side effects
Design outcomes
Primary
| Measure | Time frame |
|---|---|
| Rate of hypotension | Anesthesia begin (0 min) to 120 min after anesthesia |
Secondary
| Measure | Time frame |
|---|---|
| Consumption of ephedrine and phenylephrine | Anesthesia begin (0 min) to 120 min after anesthesia |
| Total volume of colloid or crystalloid | Fifteen minutes before anesthesia to 120 min after anesthesia |
| One-min and 5-min Apgar scores | The first and fifth minute after cesarean successful delivery |
| Recurrence of hypotension after ephedrine or phenylephrine | Anesthesia begin (0 min) to 120 min after anesthesia |
| Duration of hypotension | Anesthesia begin (0 min) to 120 min after anesthesia |
| Low umbilical cord pH (artery < 7.20) | At the time of successful delivery (0 min) |
| Oxygen saturation during hypotension | Anesthesia begin (0 min) to 120 min after anesthesia |
Countries
China
Outcome results
None listed