Spinal Anesthesia, Hypotension, Cesarian Section, Carotid Artery, Corrected Flow Time, Cardiometry
Conditions
Brief summary
This research aimed to evaluate and compare the role of carotid corrected flow time (FTc) and electrical cardiometry (EC) in the prediction and prevention of post-spinal hypotension in elective cesarian section.
Detailed description
Spinal anesthesia is the procedure of choice for elective cesarean section (CS) because it avoids the most common side effects related to general anesthesia, such as the risk of aspiration, airway problems and the negative effects of intravenous anesthetic drugs on the fetus. Accurate prediction of post-spinal hypotension could enhance clinical decision-making, optimize management, and facilitate early intervention. More than thirty predictors were used in the prediction of post-spinal hypotension including demographic data, hemodynamic variables, postural stress testing, peripheral perfusion indices, volume and fluid responsiveness indices, and genetic polymorphism. The baseline parameters obtained via the bioreactance-based system may serve as a predictor of post-spinal anesthesia hypotension in parturient.
Interventions
OTHERCarotid Ultrasound
The carotid artery corrected flow time (FTc) was used in patients to optimize the volume status before performing spinal anesthesia.
Stroke volume variation (SVV) measured by electrical cardiometry (EC) was used to optimize the volume status before performing spinal anesthesia.
Sponsors
Tanta University
Study design
Allocation
RANDOMIZED
Intervention model
PARALLEL
Primary purpose
PREVENTION
Masking
NONE
Eligibility
Sex/Gender
FEMALE
Age
18 Years to No maximum
Healthy volunteers
No
Inclusion criteria
* Aged ≥ 18 years. * American Society of Anesthesiologists (ASA) physical status II. * Gestational age (GA) ≥ 36 weeks. * Women planned elective cesarean section under spinal anesthesia.
Exclusion criteria
* Patient refusal to participate in the study. * Gestational age of \< 36 or ≥40 weeks of pregnancy. * Pregnancy-induced hypertension. * Diabetes. * Cardiovascular diseases, arrhythmia. * Antepartum hemorrhage. * Body Mass Index (BMI) above 36 kg/m2. * Clinical fetal complications.
Design outcomes
Primary
| Measure | Time frame | Description |
|---|---|---|
| The incidence of post-spinal hypotension | Intraoperatively | Incidence of spinal anesthesia-induced hypotension was measured. Post spinal hypotension is defined as a drop in the SBP to less than 80mmHg, or less than 75% of the pre-anesthetic value. Hypotension was treated by IV vasopressor boluses (Ephedrine 5 mg). |
Secondary
| Measure | Time frame | Description |
|---|---|---|
| The amount of intravenous fluids | Intraoperatively | The amount of intravenous fluids was assessed. |
| The amount of vasopressor | Intraoperatively | The amount of vasopressor was assessed. Post spinal hypotension is defined as a drop in the SBP to less than 80mmHg, or less than 75% of the pre-anesthetic value. Hypotension was treated by IV vasopressor boluses (Ephedrine 5 mg). |
| Umbilical cord PH | Immediately after fetal delivery | Umbilical cord PH was measured with fetal delivery. |
| Neonatal APGAR score | 5 minutes after fetal delivery | Neonatal APGAR score is a score between 7-10 is normal; a score between 4-6 needs proper reevaluation as the infant does require monitoring for 5 minutes. It was measured at 1, 5 minutes. |
| Complications | Intraoperatively | Complications such as bradycardia, pruritis and urine retention were measured |
Countries
Egypt
Outcome results
None listed