- ICH GCP
- US Clinical Trials Registry
- Clinical Trial NCT00796328
Up-Down Determination of the ED90 of Phenylephrine for Hypotension Prophylaxis in Cesarean Delivery
Up-down Determination of the ED90 of the Initial Rate of Infusion of Phenylephrine for the Prophylaxis of Spinal Induced Hypotension in Parturients Undergoing Cesarean Delivery
This study is designed to determine the ED90 for an infusion of phenylephrine to prevent spinal induced low blood pressure in parturients presenting for an elective cesarean delivery. The up-down methodology (UDM) is commonly used study method to determine the dose of a drug that causes the desired effect in over 90% of the subjects to whom it given. For example: the investigators want to know what is the best dose of phenylephrine (from a range of commonly used doses) to prevent a drop in blood pressure during cesarean delivery ninety times out of one hundred when it is given at that dose. The ED90 is the effective dose at which 90% of subjects will have a "positive" response to a phenylephrine infusion, i.e. no drop in blood pressure. The investigators hypothesize that the ED90 will be between 40 - 60 mcg/min.
The primary outcome measure is the ED90 for phenylephrine infusions that prevents a drop in blood pressure in women undergoing cesarean delivery.
Study Overview
Status
Intervention / Treatment
Study Type
Enrollment (Actual)
Phase
- Phase 4
Participation Criteria
Eligibility Criteria
Ages Eligible for Study
Accepts Healthy Volunteers
Genders Eligible for Study
Description
Inclusion Criteria:
- Non-emergent cesarean delivery with planned spinal anesthesia (i.e. elective planned cesarean delivery for malposition, patient choice, cervical pelvic disproportion, previous cesarean delivery and other diagnosis that require a predetermined cesarean delivery)
- American Society of Anesthesia physical status class I & II (ASA I - Healthy, ASA II - mild and controlled systemic disease, eg. controlled essential hypertension)
- Age ≥ 18 years (Standard within the obstetrical literature)
- Term gestational age
- English-speaking
Exclusion Criteria:
- Morbid Obesity (Body Mass Index ≥ 45 kg/m2) (Morbidly obese parturients require a dose of local anesthetic less than the standardized dose in this study, typically have an exaggerated response to vasopressors, and the blood pressure cuff occasionally needs to be replaced by an intra-arterial catheter due to limitations in size)
- Height < 5'0" (Women < 5'0" are likely to require a dose of local anesthetic less than the standardized dose in this study)
- Laboring women
- Urgent or emergency cesarean delivery
- Hypertensive disease of pregnancy
- Severe maternal cardiac disease
- Subjects on monoamine oxidase inhibitors (MAOI's) or tricyclic antidepressants
- Fetal anomalies or intrauterine fetal death
- Failed spinal anesthesia
- Subject enrollment in another study involving a study medication within 30 days of CD
- Any other physical or psychiatric condition which may impair their ability to cooperate with study data collection
Study Plan
How is the study designed?
Design Details
- Primary Purpose: Prevention
- Allocation: N/A
- Interventional Model: Single Group Assignment
- Masking: Quadruple
Arms and Interventions
Participant Group / Arm |
Intervention / Treatment |
---|---|
Experimental: 1
|
Up-down, biased coin design
|
What is the study measuring?
Primary Outcome Measures
Outcome Measure |
Measure Description |
Time Frame |
---|---|---|
Effective Dose of Phenylephrine at Which 90% of Subjects Have no Spinal Induced Hypotension
Time Frame: Spinal administration until delivery
|
The effective dose at which 90% of subjects will have a "positive" response to a phenylephrine infusion, i.e. no spinal induced hypotension.
We hypothesize that the ED90 will be between 40 - 60 mcg/min.
|
Spinal administration until delivery
|
Collaborators and Investigators
Sponsor
Study record dates
Study Major Dates
Study Start
Primary Completion (Actual)
Study Completion (Actual)
Study Registration Dates
First Submitted
First Submitted That Met QC Criteria
First Posted (Estimate)
Study Record Updates
Last Update Posted (Actual)
Last Update Submitted That Met QC Criteria
Last Verified
More Information
Terms related to this study
Additional Relevant MeSH Terms
- Cardiovascular Diseases
- Vascular Diseases
- Hypotension
- Physiological Effects of Drugs
- Adrenergic Agents
- Neurotransmitter Agents
- Molecular Mechanisms of Pharmacological Action
- Autonomic Agents
- Peripheral Nervous System Agents
- Protective Agents
- Adrenergic alpha-Agonists
- Adrenergic Agonists
- Cardiotonic Agents
- Respiratory System Agents
- Sympathomimetics
- Vasoconstrictor Agents
- Mydriatics
- Nasal Decongestants
- Adrenergic alpha-1 Receptor Agonists
- Phenylephrine
- Oxymetazoline
Other Study ID Numbers
- IWK-4462-2008
This information was retrieved directly from the website clinicaltrials.gov without any changes. If you have any requests to change, remove or update your study details, please contact register@clinicaltrials.gov. As soon as a change is implemented on clinicaltrials.gov, this will be updated automatically on our website as well.
Clinical Trials on Spinal Induced Hypotension in Cesarean Delivery
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Brigham and Women's HospitalCompletedSpinal Anesthesia | Hypotension During Cesarean DeliveryUnited States
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Kasr El Aini HospitalCompletedCesarean Delivery | Norepinephrine | Postspinal HypotensionEgypt
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Mersin UniversityCompletedCesarean Section Complications | Hypotension Drug-Induced | Spinal Anesthetic ToxicityTurkey
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University of British ColumbiaCompletedEpidural and Spinal Anesthesia for Cesarean DeliveryCanada
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Kasr El Aini HospitalCompletedSpinal Anesthesia | Cesarean Delivery | Non-invasive Blood PressureEgypt
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Seoul National University HospitalCompletedPregnancy | Hypotension | Cesarean DeliveryKorea, Republic of
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University of AthensCompletedCerebral Oxygen Saturation During Spinal Anesthesia for Cesarean DeliveryGreece
Clinical Trials on Phenylephrine infusion
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Cairo UniversityUnknownCesarean Section Complications | Spinal AnesthesiaEgypt
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Cairo UniversityCompletedCesarean Section Complications | Spinal AnesthesiaEgypt
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University Hospital, Basel, SwitzerlandCompletedMaternal Haemodynamic StabilitySwitzerland
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IWK Health CentreDuke UniversityCompletedHypotensionUnited States, Canada
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Aretaieion University HospitalCompletedCesarean Section Complications | Vasoconstriction | Obstetric Anesthesia Problems | Hypotension SymptomaticGreece
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University Hospital, ToulouseCompletedOrthopedic Surgery of Lower LimbFrance
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Aretaieion University HospitalAlexandra Hospital, Athens, GreeceCompletedCesarean Section Complications | Vasoconstriction | Obstetric Anesthesia Problems | Hypotension SymptomaticGreece
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Hassan II UniversityNot yet recruitingCesarean Section Complications | HypotensionMorocco
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University of Texas Southwestern Medical CenterTexas Health ResourcesRecruiting
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University of MichiganNational Institute of Diabetes and Digestive and Kidney Diseases (NIDDK)TerminatedHypertension | Chronic Kidney DiseaseUnited States