Anesthesia, Obstetrical, Anesthesia, Spinal
Conditions
Keywords
Orthostatic, Cesarean section, Pregnant, Phenyephrine, Hypotension
Brief summary
Pregnant women with a positive preoperative Supine stress test were found to be a subgroup at increased risk of symptomatic hypotension after spinal anesthesia
Detailed description
Patients will be placed in dorsal decubitus dislocating the uterus to the left for a few minutes, with blood pressure and heart rate recorded three times, with a three-minute interval between measurements to obtain mean baseline levels and this will be repeated in an upright position to record the same measurement.Orthostatic hypotension (Orthostatic hypotension OH is defined specifically as a 20mmHg drop in systolic, and/or a 10mmHg drop in diastolic blood pressure within 3 minutes of standing.
Interventions
DRUGPhenylephrine
it will be given as a prophylaxis for prevention of hypotension after spinal anesthesia in pregnant patients undergoing cesarean section
OTHERPlacebo
5 ml normal saline will be given before spinal anesthesia
Sponsors
Assiut University
Study design
Allocation
RANDOMIZED
Intervention model
PARALLEL
Primary purpose
PREVENTION
Masking
TRIPLE (Subject, Caregiver, Outcomes Assessor)
Eligibility
Sex/Gender
FEMALE
Age
18 Years to 50 Years
Healthy volunteers
No
Inclusion criteria
Physical status ASA I, A full term pregnancy A single fetus Elective cesarean section.
Exclusion criteria
Refusal of the patient to participate in the study History of hypertension Pregnancy-induced hypertension Cardiovascular or cerebrovascular disease Fetal abnormalities History of hypersensitivity to the drugs used Contraindications to spinal block.
Design outcomes
Primary
| Measure | Time frame | Description |
|---|---|---|
| Incidence of hypotension | within first 24 hours after spinal anesthesia | blood pressure will be measured every 3 minutes within the first 30 minutes after spinal block the every 5 minutes till the end of the caesarian section. postoperatively will be checked every 15 minutes in the first hour the every 30 minutes till the recovery from spinal block |
Secondary
| Measure | Time frame | Description |
|---|---|---|
| Frequency of bradycardia | within first 24 hours after spinal anesthesia | heart rate will be measured every 5 minutes till the end of the caesarian section. postoperatively will be checked every 15 minutes in the first hour the every 30 minutes till the recovery from spinal block |
| Ephedrine usage | within first 24 hours after spinal anesthesia | Total amount of ephedrine given |
| intraoperative fluid management | within first 24 hours after spinal anesthesia | Total amount of fluid given |
| Apgar scores | within first 24 hours after spinal anesthesia | Apgar scores in the first and fifth minutes of the newborns |
Countries
Egypt
Outcome results
None listed