Effect of Spinal Anesthesia in Elective Cesarean Cases on Frontal QRS Angle in Anemic and Non-Anemic Patients

Comparison of the Effect of Spinal Anesthesia Applied in Elective Cesarean Cases on Frontal QRS Angle in Anemic and Non-Anemic Patients

The QRS-T angle represents a novel marker of myocardial repolarisation. It is defined as the angle difference between the direction of ventricular depolarisation (QRS wave) and the direction of ventricular repolarisation (T wave). It is an indicator of instability in the electrophysiological properties of the myocardium and is associated with arrhythmias. The frontal QRS-T angle is a straightforward, cost-effective parameter that can be readily obtained from 12-lead electrocardiography.

The most prevalent arrhythmias during pregnancy are atrial arrhythmias. However, ventricular tachyarrhythmias are exceedingly rare during pregnancy and may be life-threatening.

Caesarean section is one of the most common surgical procedures. General anaesthesia, spinal anaesthesia and epidural anaesthesia can be employed in these patients. Spinal anaesthesia is a frequently employed method in caesarean section operations due to its rapid onset of effect, technical simplicity of application and higher probability of success.

In pregnant women, anaemia is defined as a haemoglobin concentration below 11 mg/dL in the first trimester, 11 mg/dL in the second trimester and 10.5 mg/dL in the third trimester.

Study Overview

• Status: Recruiting
• Conditions: Pregnancy Anemia; Electrocardiography; Anesthesia, Spinal

Detailed Description

The QRS-T angle represents a novel marker of myocardial repolarisation. It is defined as the angle difference between the direction of ventricular depolarisation (QRS wave) and the direction of ventricular repolarisation (T wave). It is an indicator of instability in the electrophysiological properties of the myocardium and is associated with arrhythmias. The frontal QRS-T angle is a straightforward, cost-effective parameter that can be readily derived from 12-lead electrocardiography. The angle between the QRS and T waves is a useful indicator of myocardial repolarisation. It is associated with arrhythmias and instability in the electrophysiological properties of the myocardium. The frontal QRS-T angle is a simple, inexpensive parameter that can be easily obtained from 12-lead electrocardiography.

Pregnancy has a profound effect on the cardiovascular system. It results in an increase in blood volume, heart rate, venous pressure in the lower extremities, and cardiac output. Furthermore, it can result in a reduction in peripheral resistance and pulmonary vascular resistance, as well as a decline in blood pressure. Furthermore, it affects the cardiac conduction system, rendering patients more susceptible to arrhythmias. The most prevalent arrhythmias during pregnancy are atrial arrhythmias. Ventricular tachyarrhythmias are relatively uncommon during pregnancy and can be life-threatening.

One of the most common surgical procedures is caesarean section. General anaesthesia, spinal anaesthesia and epidural anaesthesia can be employed in these patients. Spinal anaesthesia is a frequently employed method in caesarean section operations due to its rapid onset of effect, technical ease of application and higher chance of success. In addition to the beneficial effects, direct cardiac and indirect cardiac side effects may be observed, such as vasodilatation due to sympathetic denervation, decreased right heart pressure and reflex bradycardia, which depend on the level of block.

In pregnant women, haemoglobin values below 11 mg/dL in the first trimester, 11 mg/dL in the second trimester and 10.5 mg/dL in the third trimester are considered to indicate anaemia.

The objective of this study was to investigate the effects of spinal anaesthesia in elective caesarean section cases on frontal QRS angle in anaemic and non-anaemic patients.

• Study Type: Observational
• Enrollment (Estimated): 100

Contacts and Locations

• Study Contact: Name: ahmet kaya; Phone Number: 00905327010609; Email: ahmet.kaya@sbu.edu.tr
• Study Contact Backup: Name: mahmut alp karahan; Phone Number: 00905327808997; Email: mahmutalp_k@yahoo.com

Study Locations

• Turkey
  • Şanlıurfa, Turkey, 63050
    • Recruiting
    • University of Health Science Turkey Sanliurfa Mehmet Akif Inan Training and Research Hospital
    • Contact: ahmet kaya; Phone Number: 00905327010609; Email: ahmet.kaya@sbu.edu.tr
    • Contact: mahmut alp karahan; Phone Number: 00905327808997; Email: mahmutalp_k@yahoo.com

Participation Criteria

Eligibility Criteria

• Ages Eligible for Study: Adult
• Accepts Healthy Volunteers: No

• Sampling Method: Non-Probability Sample

Study Population

The study will include 100 patients aged 18-45 years with an American Society of Anesthesiologists (ASA) II classification who will undergo elective caesarean section.

Description

Inclusion Criteria:

• Aged 18-45 years
• Patients with American Society of Anesthesiologists (ASA) II classification

Exclusion Criteria:

• Patients with rhythm disorders
• Patients with electrolyte disturbances
• Patients with liver and/or renal failure
• Obese patients (body mass index > 30)
• Trauma patients
• Cancer patients
• ASA III-IV patients
• Patients who do not wish to participate in the study will be excluded.

Study Plan

How is the study designed?

Number of groups / cohorts

2

Cohorts and Interventions

Group / Cohort
Patients who had undergone Elective Cesarean Surgery with anemia; In pregnant women, haemoglobin values below 11 mg/dL in the first trimester, 11 mg/dL in the second trimester and 10.5 mg/dL in the third trimester indicate anaemia. The group comprised patients with haemoglobin levels below 10.5 mg/dL.
Patients who had undergone Elective Cesarean Surgery without anemia; In pregnant women, haemoglobin values below 11 mg/dL in the first trimester, 11 mg/dL in the second trimester and 10.5 mg/dL in the third trimester indicate anaemia. The group comprised patients with haemoglobin levels above 10.5 mg/dL.

What is the study measuring?

Primary Outcome Measures

Outcome Measure	Time Frame
The measurements to be taken include QRS, frontal QRS, QRS angle and Tp-e interval. (T1)	preoperatively
The measurements to be taken include QRS, frontal QRS, QRS angle and Tp-e interval.(T2)	after spinal anaesthesia
The measurements to be taken include QRS, frontal QRS, QRS angle and Tp-e interval.(T3)	5 min after spinal anaesthesia
The measurements to be taken include QRS, frontal QRS, QRS angle and Tp-e interval.(T4)	5 min after spinal anaesthesia
The measurements to be taken include QRS, frontal QRS, QRS angle and Tp-e interval.(T5)	10 min after spinal anaesthesia

Collaborators and Investigators

• Sponsor: Sanliurfa Mehmet Akif Inan Education and Research Hospital

Study record dates

Study Major Dates

• Study Start (Actual): April 20, 2024
• Primary Completion (Estimated): August 31, 2024
• Study Completion (Estimated): August 31, 2024

Study Registration Dates

• First Submitted: May 22, 2024
• First Submitted That Met QC Criteria: May 22, 2024
• First Posted (Actual): May 30, 2024

Study Record Updates

• Last Update Posted (Actual): May 30, 2024
• Last Update Submitted That Met QC Criteria: May 22, 2024
• Last Verified: May 1, 2024

More Information

Terms related to this study

• Other Study ID Numbers: MAIEAH630004

Drug and device information, study documents

• Studies a U.S. FDA-regulated drug product: No
• Studies a U.S. FDA-regulated device product: No