Hypotension
Conditions
Keywords
cesarean, spinal anesthesia, hypotension, norepinephrine, ephedrine, phenylephrine, sympathetic block
Brief summary
Comparison of two practices of obstetrical services between the CHU of Clermont Ferrand and the HFME Lyon-Bron in the management of arterial hypotension during an elective cesarean section
Detailed description
The investigators propose to carry out a bicentric strict observational prospective study between the maternity of the HFME of Lyon-Bron which uses the mixture ephedrine / noradrenaline with the PSE for many years in service protocol for the management of hypotension for cesarean section under perimedullary anesthesia and the CHU of Clermont-Ferrand which uses baby noradrenaline 10 mcg/mL PSE for this same indication according to an institutional protocol. Patients corresponding to the inclusion and non-inclusion criteria will be recruited by a physician investigator and will give their agreement of non-opposition after having received clear oral and written information about our study. The care will not be modified in any way compared to the usual practices of the service.
Interventions
None listed
Sponsors
University Hospital, Clermont-Ferrand
Study design
Observational model
OTHER
Time perspective
PROSPECTIVE
Eligibility
Sex/Gender
FEMALE
Age
18 Years to 55 Years
Healthy volunteers
Yes
Inclusion criteria
* elective caesarean * ≥ 18 years old * term ≥ 36 weeks amenorrhea
Exclusion criteria
* contraindication of local anesthetics * contraindication of spinal anesthesia * patient's refusal * patient doesn't talk French * patient not covered by the social security system
Design outcomes
Primary
| Measure | Time frame | Description |
|---|---|---|
| Systolic blood pressure | duration of the procedure up to one hour | Time-weighted mean intraoperative systolic blood pressure below a threshold of 80mmHg, 90mmHg and 100mmHg. This measurement is commonly called TWA (time weighted average), corresponding to the area between the chosen PAS threshold and the curve of the measured PAS, divided by the total time of the measurements. Blood pressure will be measured by the Clearsight system, absolutely non-invasive continuous pulse wave contour monitoring. |
Secondary
| Measure | Time frame | Description |
|---|---|---|
| Foetal pH | at birth | arterial and venous |
| boli of vasopressor | duration of the procedure up to one hour | appeal to boli of ephedrine and/or phenylephrine and/or noradrenaline |
| boli of atropine | duration of the procedure up to one hour | appeal to boli of atropine |
| Clinical sign of hypotension | duration of the procedure up to one hour | nausea, vomiting, faint |
| total diuresis | duration of the procedure up to one hour | — |
| intrathecal local anesthetics | duration of the procedure up to one hour | amount of intrathecal local anesthetics injected |
| crystalloids | duration of the procedure up to one hour | volume of crystalloids infused |
Countries
France
Contacts
Primary ContactLise Laclautre
Outcome results
None listed