Anesthesia, Spinal, Nonemergency Cesarean Section
Conditions
Keywords
Anaesthesia, Spinal, Caesarean Section, Hyperbaric bupivacaine, Hemodynamic management after spinal anaesthesia, Maternal experience
Brief summary
Most of caesarean sections can be performed under spinal anaesthesia. Its major advantages are reliability and fast onset. However, dose of hyperbaric bupivacaine used, combination with adjuvants, hemodynamic management, and impact of these measures on maternal experience are not uniform. This study aims to describe practices of spinal anaesthesia for caesarean section in France to improve practices, guide new studies and establish protocols.
Detailed description
Most of caesarean sections can be performed under spinal anaesthesia. Its major advantages are reliability and fast onset. However, techniques of spinal anaesthesia are varied. Dose of hyperbaric bupivacaine used may shifted, varying intensity of sensor block but also hemodynamic side effect. Likewise, use of adjuvant is frequent and differs between centres. Management of the maternal hemodynamic is also discussed. While it is recognized that intraoperatively vascular filling alone is not effective, use of vasopressors is not unequivocal. For example, recent studies support the use of norepinephrine. Finally, maternal experience is a hot topic. Although insufficient anaesthesia is rare, it is often overlooked. There are few recommendations on the intraoperative treatment of insufficient anaesthesia and to the management of post-traumatic stress that it lead to. The objective of this study is to describe practices of spinal anaesthesia for scheduled or non-emergency caesarean section (also named green code) in France by detailing several points: Technique of spinal anaesthesia: * The anaesthesia solution used (doses and adjuvants) * Management of hemodynamic * Management of insufficient anaesthesia * Maternal experience It aims to make an inventory of practices, to orient future studies, guide practice and the realization of protocols. It is an observational study unfolds from 2021 to 2022. It concerns 11 French centres and 600 women. Data are collected with an online questionnaire.
Interventions
PROCEDURESpinal anaesthesia for caesarean section
Descriptive questionnaire with open and closed questions, to be completed during the procedure
Sponsors
University Hospital, Clermont-Ferrand
Study design
Observational model
COHORT
Time perspective
PROSPECTIVE
Eligibility
Sex/Gender
FEMALE
Age
18 Years to No maximum
Healthy volunteers
Yes
Inclusion criteria
* Age ≥ 18 years old * Affiliation to social security system * Scheduled or elective Caesarean section (green code) under spinal anesthesia
Exclusion criteria
* Refusal to participate in the study * Code red Caesarean section or general anesthesia decision * Complicated Caesarean section or combined spinal-epidural technique * Presence of an epidural catheter * Performing a combined spinal-epidural technique (even if the epidural catheter is not used) * Contraindication to spinal anaesthesia (coagulation disorder, vertebral-medullary pathologies) * Patient under guardianship or curatorship
Design outcomes
Primary
| Measure | Time frame | Description |
|---|---|---|
| Maternal data | Day of surgery | Ad hoc Questionnaire |
| Obstetrical data | Day of surgery | Ad hoc Questionnaire |
| Spinal procedure | Day of surgery | Ad hoc Questionnaire |
| Haemodynamic management | Day of surgery | Ad hoc Questionnaire |
| Maternal experience | Day of surgery | Ad hoc Questionnaire |
Countries
France
Outcome results
None listed