Cardiac Output Changes During Hyperbaric and Isobaric Bupivacaine in Patients Undergoing Cesarean Section

Mahidol University168 enrolled

Overview

Spinal block leads to the reduction of systemic vascular resistance (SVR) which may effect the cardiac output. Ngan Kee et al. has showed that spina block with 0.5% hyperbaric bupivacaine for Cesarean section combined with intravenous infusion norepinephrine had higher cardiac output than those who received phenylephrine

Study Type

INTERVENTIONAL

Allocation

RANDOMIZED

Purpose

TREATMENT

Masking

QUADRUPLE

Enrollment

168

Conditions

Cardiac Output Hypotension Anesthesia, Spinal

Interventions

Isobaric marcaineDRUG

Isobaric marcaine 2.2 mL for spinal block

Hyperbaric marcaineDRUG

Hyperbaric marcaine 2.2 mL for spinal block

Eligibility

Sex: FEMALEMin age: 18 Years

Medical Language ↔ Plain English

Inclusion Criteria: * American Society of Anesthesiology classification I - II * Elective or urgency Cesarean section with spinal block e.g. cephalopelvic disproportion, premature rupture of membrane * Singleton pregnancy * Body mass index \< 40 kg/m2 Exclusion Criteria: * Pregnancy \<35 weeks gestational age * Hypertensive disease e.g. gestational hypertension, chronic hypertension, preeclampsia * History of allergy to the study drugs

Locations (1)

Department of Anesthesiology, Faculty of Medicine, Siriraj Hospital, Mahidol University

Bangkok, Thailand

Outcomes

Primary Outcomes

Change of cardiac output (L/min) after spinal block

The investigators will measure cardiac output using non-invasive methods (USCOM) before spinal block and 5 minutes after spinal block.

Time frame: 5 minutes after spinal block

Secondary Outcomes

Total dose of vasopressor

The investigators will record the total dose that treat hypotension during preoperative period

Time frame: 2 hours

Number of patients who experience systolic blood pressure < 25% of preoperative measurement

The investigators will monitor blood pressure at interval; before spinal block, then after spinal block every 1 minute for 10 for 10 times, every 2 minute for 5 times, every 3 minutes until delivery then every 5 minutes til the end of surgery. If the patient's systolic blood pressure is declined, vasopressor will be given.

Time frame: 2 hours

Data from ClinicalTrials.gov

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