Cesarean Section, Spinal Anesthesia
Conditions
Brief summary
Spinal anesthesia is widely accepted as the anesthetic method of choice for Cesarean section. However, the incidence of spinal hypotension is 50-70%, and the decrease in blood pressure is often rapid and severe. Heart rate variability is influenced by various factors such as the sympathetic nervous system, parasympathetic nervous system, temperature regulation, baroreflex, and endocrine regulation, but high frequency heart rate variability above 0.15 Hz very specifically reflects the parasympathetic nervous system. The ANI monitor calculates heart rate variability mediated by changes in the parasympathetic nervous system. This study aims to determine whether ANI monitor can predict hypotension in patients undergoing a caesarean section under spinal anaesthesia while applying the preemptive vasopressor phenylephrine infusion protocol.
Interventions
OTHERobservation
The ANI monitor calculates heart rate variability mediated by changes in the parasympathetic nervous system.
Sponsors
Yonsei University
Study design
Observational model
COHORT
Time perspective
PROSPECTIVE
Eligibility
Sex/Gender
FEMALE
Age
20 Years to No maximum
Healthy volunteers
Yes
Inclusion criteria
* full-term parturients undergoing cesarean delivery
Exclusion criteria
* emergent surgery, placenta previa, Morbid obesity with a BMI ≥ 40 kg/m2, Gestational age \< 36 or ≥ 41 weeks, Contraindications to spinal anesthesia, cardiac arrhythmia, implantable pacemaker, diseases affecting the autoimmune system (such as immune disease or diabetic neuropathy), use of medications affecting ANI monitoring (antimuscarinics, alpha-agonists, beta blockers), illiteracy, or foreigners
Design outcomes
Primary
| Measure | Time frame | Description |
|---|---|---|
| predictive value of ANI monitor for spinal hypotension during cesarean delivery | the occurence of hypotension at (within) 1 hour after spinal anesthesia | Investigators will determine the predictive power of the ANI score change for the occurrence of hypotension after spinal anesthesia by drawing a receiver operating characteristic (ROC) curve of the change in ANI score (baseline value - minimum value) and calculating the area under the ROC curve. |
Secondary
| Measure | Time frame | Description |
|---|---|---|
| Optimal cutoff value of ANI level for predicting occurrence of hypotension | the occurence of hypotension at (within) 1 hour after spinal anesthesia | Investigators will determine the optimal cutoff value of ANI level for predicting hypotension after spinal anesthesia. |
Countries
South Korea
Contacts
Primary ContactSeung Hyun Kim, Associate Professor
Outcome results
None listed