- ICH GCP
- US Clinical Trials Registry
- Clinical Trial NCT04010318
Plethysmographic Variability Index in Post Spinal Anesthesia Hypotension in Cesarean Section
The Sensitivity of Goal Plethysmography Variability Index (PVI) Directed Pre-anesthesia Intravenous Fluid Infusion in the Prevention of Spinal Anesthesia Induced Hypotension in Elective Caesarian Section: Prospective Observational Study
- Full term pregnant female patients presented for elective C.S for single viable fetus will be included in this study.
- Before anesthesia, the patient will be attached to a monitor of: ECG , heart rate, non invasive blood pressure, pulse taximeter applied on the index finger of the limb not attached to the blood pressure cuff, pulse oximetry and plethysmographic variability index (PVI) and perfusion index (PI) will be taken by (Massimo radical 7, Massimo corp. USA). Measures will be recorded every 5 minutes preoperative.
- Patients with PVI <15 will be excluded from the study.
- Patients with PVI > 15 are started on intravenous infusion of warm ringer lactate solution via suitable pore intravenous cannula to reach target of PVI <15 or a total 1 liter of ringer lactate.
- The patients in which the PVI is corrected by fluid to level below 15 will be Group (C) or corrected group. Patients in which intravenous fluid administration did not result any change in PVI or changed but still higher than 15 will be Group (NC) or non corrected group.
After preoperative preparation patient is shifted to operating theater, with all monitors applied. She will receive spinal block at lumbar 3-4 space with hyperbaric bupivacaine 8 mg plus 25 mic fentanyl. After giving anesthesia and positioning for surgery with a left lateral tilt of 15 degrees,
Study Overview
Status
Intervention / Treatment
Detailed Description
- This prospective observational study will be carried out on all pregnant women who will undergo elective cesarean section in obstetric department in Tanta university hospitals under spinal anesthesia over four month duration that starts immediately after obtaining ethical committee approval, an informed written consent will be included with the consent for spinal anesthesia for cesarean section, all patients data will be confidential and will be used for the current study only.
- Inclusion criteria:
Pregnant women which are listed to undergo elective caeserian section for single viable baby under spinal anesthesia.
Exclusion criteria:
- Patients with pregnancy less than 36 weeks or more than 40 weeks
- Patients with hypertension , pre-eclampsia , eclampsia.
- Patients with diabetes
- Patients with cardiovascular disease and /or arrhythmia.
- Patients with placenta previa, accreta, percreta.
- Obese patients with BMI >36
- Polyhydramnious patients
- On arrival of patients to pre-anaesthesia preparation room, we will allow patients to rest in supine position with 15 degree left tilt by pillow wedge under right hip, after allowing patient to rest for five minutes, measures are recorded: ECG , heart rate, non invasive blood pressure, pulse oximeter applied on the index finger of the limb not attached to the blood pressure cuff, pulse oximetry and Plethysmography variability index (PVI) and perfusion index (PI) will be taken by (Massimo radical 7, Massimo corp. USA). Measures will be recorded every 5 minutes preoperative. Patients with PVI <15 are excluded from the study.
Patients with PVI > 15 are started on intravenous infusion of warm ringer lactate solution via suitable pore intravenous cannula to reach target of PVI <15 or a total 1 liter of ringer lactate.
The patients in which the PVI is corrected by fluid to level below 15 will be Group (C) or corrected group. Patients in which intravenous fluid administration did not result any change in PVI or changed but still higher than 15 will be Group (NC) or non corrected group.
After preoperative preparation patient is shifted to operating theater, with all monitors applied. She will receive spinal block at lumbar 3-4 space with hyperbaric bupivacaine 8 mg plus 25 mic fentanyl. After giving anesthesia and positioning for surgery with a left lateral tilt of 15 degrees, supplemental oxygen at rate of 4 liter/minute is applied.
Measurements will be taken every minute till delivery of the baby, and if the blood pressure is decreased below 20% of the baseline level before anesthesia, patients will be given incremental doses of ephedrine sulfate 0.1 mg /kg till blood pressure normalized above 80% of pre-anesthesia level. All measurements will be recorded in tables and subjected to statistical analysis.
Study Type
Enrollment (Actual)
Contacts and Locations
Study Locations
-
-
-
Tanta, Egypt, 31511
- Tanta University Hospitals
-
-
Algharbia Governate
-
Tanta, Algharbia Governate, Egypt, 31511
- Tanta University Hospitals
-
-
Participation Criteria
Eligibility Criteria
Ages Eligible for Study
Accepts Healthy Volunteers
Genders Eligible for Study
Sampling Method
Study Population
Description
Inclusion Criteria:
- Pregnant women which are listed to undergo elective caeserian section for single viable baby under spinal anesthesia.
Exclusion Criteria:
- Patients with pregnancy less than 36 weeks or more than 40 weeks, Patients with hypertension , pre-eclampsia , eclampsia, Patients with diabetes, Patients with cardiovascular disease and /or arrhythmia, Patients with placenta previa , accreta, percreta, Obese patients with BMI >36, or Polyhydramnious patients.
Study Plan
How is the study designed?
Design Details
Cohorts and Interventions
Group / Cohort |
Intervention / Treatment |
---|---|
Corrected group
The patients in which the PVI will corrected by fluid to level below 15
|
The patients will receive spinal block at lumbar 3-4 space with hyperbaric bupivacaine 8 mg plus 25 mic fentanyl.
After giving anesthesia and positioning for surgery with a left lateral tilt of 15 degrees, supplemental oxygen at rate of 4 liter/minute is applied.
|
Uncorrected group
Patients in which intravenous fluid administration didn't result any change in PVI or changed but still higher than 15
|
The patients will receive spinal block at lumbar 3-4 space with hyperbaric bupivacaine 8 mg plus 25 mic fentanyl.
After giving anesthesia and positioning for surgery with a left lateral tilt of 15 degrees, supplemental oxygen at rate of 4 liter/minute is applied.
|
What is the study measuring?
Primary Outcome Measures
Outcome Measure |
Measure Description |
Time Frame |
---|---|---|
The incidence of post-spinal anesthesia hypotension
Time Frame: Through out the whole intraoperative period
|
The decrease in the mean arterial pressure below 65 mmHg or below 80% of the baseline value.
|
Through out the whole intraoperative period
|
Secondary Outcome Measures
Outcome Measure |
Measure Description |
Time Frame |
---|---|---|
The consumption of vasopressors
Time Frame: Through out the whole intraoperative period
|
The total dose of ephedrine required to maintain the MAP above 80% of the baseline value
|
Through out the whole intraoperative period
|
Collaborators and Investigators
Sponsor
Study record dates
Study Major Dates
Study Start (ACTUAL)
Primary Completion (ACTUAL)
Study Completion (ACTUAL)
Study Registration Dates
First Submitted
First Submitted That Met QC Criteria
First Posted (ACTUAL)
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
Other Study ID Numbers
- 33109/05/19
Plan for Individual participant data (IPD)
Plan to Share Individual Participant Data (IPD)?
IPD Plan Description
Drug and device information, study documents
Studies a U.S. FDA-regulated drug product
Studies a U.S. FDA-regulated device product
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 Complication of Anaesthesia During Labour and Delivery
-
University of BolognaUnknownVacuum Extraction; Failure, Affecting Fetus or Newborn | Persistent Occiput Posterior Position During Labor | Complication of DeliveryItaly
-
IWK Health CentreCompletedAirway Complication of Anaesthesia
-
Yonsei UniversityCompletedAirway Complication of AnaesthesiaKorea, Republic of
-
Theodor Bilharz Research InstituteCompletedAirway Complication of AnaesthesiaEgypt
-
University of FloridaWithdrawnAirway Complication of AnaesthesiaUnited States
-
Assistance Publique - Hôpitaux de ParisRecruitingEpidural Analgesia for Labour and DeliveryFrance
-
Arkansas Children's Hospital Research InstituteCompletedInterface Acceptance During Delivery of Aerosol Medicine to an Infant or ChildUnited States
-
University of British ColumbiaMassage Therapy Foundation; Holistic Health ResearchCompleted
-
Saint Thomas Hospital, PanamaCompleted
-
University Hospital, GhentCompletedPain Relief During LabourBelgium
Clinical Trials on Spinal Anesthesia
-
Sao Jose do Rio Preto Medical SchoolUnknownHip Fractures | Knee Arthroplasty | Femur FractureBrazil
-
National Taiwan University HospitalCompleted
-
University Hospital, AntwerpTerminatedAnesthesia; Adverse Effect, Spinal and EpiduralBelgium
-
The Cleveland ClinicCompletedScoliosis | Patients Aged 55 or Older | BMI More Than 40 kg/m2United States
-
Bakirkoy Dr. Sadi Konuk Research and Training HospitalCompletedPregnancy Related | Regional Anesthesia Morbidity | Postdural Puncture HeadacheTurkey
-
Fraser HealthNot yet recruitingAnesthesia, Spinal | Neurosurgery | Ropivacaine | BupivacaineCanada
-
Cairo UniversityUnknownParamedian Spinal Anaesthesia | Real Time Ultrasound GuidingEgypt
-
Stanford UniversityWithdrawnHeadache | HypotensionUnited States
-
Ankara UniversityAhmet Onat Bermede; Süheyla Karadağ Erkoç; Volkan Baytaş; Bulut Varlı; Hanife Asuman...Completed
-
Diskapi Teaching and Research HospitalCompletedKnee Arthropathy | Hip Arthropathy | Anesthesia; Adverse Effect, Spinal and EpiduralTurkey