The Effect of the Timing of Colloid and Crystalloid Infusions on Postspinal Hypotension After Spinal Anesthesia for Caesarian Section

Balikesir University80 enrolled

Overview

Prevention of postspinal hypotension after spinal anesthesia for caesarian section by use of preoperative or intraoperative volume replacement. The comparison of crystalloid and colloid infusions and their timing via perfusion index and plethysmographic variability index.

To Prevent hypotension fluid replacement is usually used in pregnant patients scheduled for C/S. Different types of fluids can be used in order to achieve this. Also the timing of fluid replacement is important. In the present study patients were separated into 4 groups. Each receiving a one of two fluids in different times. ( Colloid pre-load, colloid co-load, crystalloid co-load and crystalloid pre-load.) The effect of overall hemodynamics and the incidence of hypotension are evaluated. Also peripheric monitors like perfusion index and plethysmographic variability index are evaluated for correlation.

Study Type

INTERVENTIONAL

Allocation

RANDOMIZED

Purpose

PREVENTION

Masking

TRIPLE

Enrollment

Conditions

Complications; Anesthesia, Spinal and Epidural, in Pregnancy

Interventions

Colloid PreloadOTHER

preload infusion

colloid co-loadOTHER

co-load infusion

Crystalloid preloadOTHER

preload infusion

Crystalloid Co-load

Eligibility

Sex: FEMALEMin age: 18 YearsMax age: 50 YearsHealthy volunteers:

Medical Language ↔ Plain English

Inclusion Criteria: * pregnant 37-41 weeks * one fetus * scheduled for C/S under spinal anesthesia * accepting to participate Exclusion Criteria: * Emergency surgery * placenta previa * preeclampsia * cardiovascular and cerebrovascular comorbidities * morbid obesity (BMI\>40) * pregnancy weeks \<36 and \> 41 * The use of vasoconstrictors * Severe Anemia ( Hb \<9 g/dl) * Refusal or known contraindication for spinal anesthesia

Locations (1)

Balikesir University Faculty of Medicine

Balıkesir, Turkey (Türkiye)

Outcomes

Primary Outcomes

Number of participants in each group who develop hypotension, and correlation between hypotension and Perfusion Index (PI) and Plethysmographic Variability Index (PVI) scores

Hypotension is going tobe measured in mmHG in 5 minute intervals and PI and PVI measurements are also recorded at the same time intervals. A decrease in blood presssure exceeding % 20 of the preoperative basal blood pressure measurement will be recorded as hypotension. The number of patients who develop hypotension will be recorded. Statistic difference will be avaluated between groups. Hypotensive episodes are going to be comparised with the PI and PVI measurements at the same time period and evaluation for correlation will be performed.

Time frame: Measurements will be performed at 5 minute intervals beginning 15 minutes prior to the operation, throughout the whole operation untill the end.

Data from ClinicalTrials.gov

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