This is a study of pregnant women undergoing a cesarean delivery. It will compare their microcirculation before and after the anesthetic. Microcirculation means blood flow to the extremely small blood vessels in the body. It will also look at the differences in microcirculation of participants who receive an infusion of phenylephrine compared to participants who don't. The investigators hypothesize that spinal anesthesia will reduce the vascular density and proportion of perfused vessels.
Study Type
INTERVENTIONAL
Allocation
RANDOMIZED
Purpose
TREATMENT
Masking
NONE
Enrollment
32
Initial SDF measurements are recorded in the obstetric preoperative area within two hours prior to administration of spinal anesthesia.
The spinal anesthetic technique is standardized. In the operating room spinal anesthesia will be administered with the L2-L5 interspaces in the sitting position using 12 mg of hyperbaric bupivacaine with 15 mcg of fentanyl and 150 mcg of preservative free morphine.
A second comparative SDF measurement be recorded within 10 minutes after induction of spinal anesthesia.
IWK Health Centre
Halifax, Nova Scotia, Canada
Microvascular Flow Index (MFI)
The change in MFI of participants; measured immediately prior to, and within 10 minutes following the induction of spinal anesthesia
Time frame: Immediately prior to, and within 10 minutes of induction of spinal anesthesia
Microvascular Flow Index (MFI)
The difference between the MFI measured within 10 minutes following the induction of spinal anesthesia in participants who receive phenylephrine via a continuous infusion for the prevention of spinal anesthesia-induced hypotension compared to those who may receive phenylephrine boluses for treatment of spinal anesthesia-induced hypotension.
Time frame: Immediately prior to, and within 10 minutes of induction of spinal anesthesia
This platform is for informational purposes only and does not constitute medical advice. Always consult a qualified healthcare professional.
Participants who experience hypotension following induction of spinal anesthesia will be treated with a bolus of phenylephrine and/or ephedrine as needed.
Participants will have an infusion of phenylephrine started immediately following the induction of spinal anesthesia for prevention of hypotension.