The study aims to compare crystalloid co-loading and colloid co-loading in parturients receiving prophylactic phenylephrine infusion during cesarean delivery in terms of the incidence of hypotension.
Study Type
INTERVENTIONAL
Allocation
RANDOMIZED
Purpose
PREVENTION
Masking
QUADRUPLE
Enrollment
100
Patients will receive the rapid co-loading with plasma solution A (PSA) 10ml/kg, from the initiation of spinal anesthesia, within 10 minutes.
Patients will receive the rapid co-loading with 6% volulyte (HES in acetated electrolyte) 10ml/kg, from the initiation of spinal anesthesia, within 10 minutes.
Seoul National University Hospital
Seoul, South Korea
Incidence of maternal hypotension
defined as: Systolic Blood Pressure (SBP) \< 80% of baseline SBP
Time frame: during the time period from induction of spinal anesthesia until delivery
incidence of severe hypotension
defined as: Systolic Blood Pressure (SBP) \< 70% of baseline SBP
Time frame: during the time period from induction of spinal anesthesia until delivery
incidence of symptomatic hypotension
defined as: hypotension plus nausea and/or vomiting and/or dizziness and/or breathlessness
Time frame: during the time period from induction of spinal anesthesia until delivery
incidence of bradycardia
Heart Rate (HR) \<50 bpm
Time frame: during the time period from induction of spinal anesthesia until delivery
incidence of Hypertension
Systolic Blood Pressure (SBP)\> 120% of baseline SBP
Time frame: during the time period from induction of spinal anesthesia until delivery
Minimum recorded Systolic Blood Pressure (Minimum SBP)
The lowest recorded SBP during the time period from induction of spinal anesthesia until delivery
Time frame: during the time period from induction of spinal anesthesia until delivery
Minimum recorded Heart Rate (Minimum HR)
The lowest recorded HR during the time period from induction of spinal anesthesia until delivery
Time frame: during the time period from induction of spinal anesthesia until delivery
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Cumulative duration of hypotension
duration of hypotension, minutes
Time frame: during the time period from induction of spinal anesthesia until delivery
Onset time of hypotension
Time from the induction of spinal anesthesia until the first event of hypotension occur
Time frame: during the time period from induction of spinal anesthesia until delivery
Total phenylephrine use
Cumulative dose of phenylephrine administered via continuous infusion, mcg
Time frame: during the time period from induction of spinal anesthesia until delivery
Rescue phenylephrine use
number of patients who require the rescue use of phenylephrine
Time frame: during the time period from induction of spinal anesthesia until delivery
Rescue ephedrine use
number of patients who require the rescue use of ephedrine
Time frame: during the time period from induction of spinal anesthesia until delivery
Atropine use
number of patients who require the rescue use of atropine
Time frame: during the time period from induction of spinal anesthesia until delivery
Incidence of nausea, vomiting
The incidence of nausea, vomiting
Time frame: during the time period from induction of spinal anesthesia until delivery
Incidence of dizziness, breathlessness
The incidence of dizziness, breathlessness
Time frame: during the time period from induction of spinal anesthesia until delivery
Cutaneous stellate ganglion sympathetic activity
noninvasive recording of skin sympathetic nerve activity (SKNA) using conventional ECG electrodes
Time frame: during the time period from induction of spinal anesthesia until delivery
Apgar Score, 1 min, 5 min (fetal outcome)
Apgar Score of delivered baby. The Apgar score is determined by evaluating the newborn baby on five simple criteria on a scale from zero to two, then summing up the five values thus obtained. The resulting Apgar score ranges from zero to 10. The five criteria are the Appearance, Pulse, Grimace, Activity, and Respiration. Each is scored on a scale of 0 to 2, with 2 being the best score. The test is done at 1 and 5 minutes after birth.
Time frame: 1 min, 5 min after delivery
Umbilical arterial pH
pH of Umbilical Arterial blood gas analysis (ABGA) (fetal outcome)
Time frame: immediately after delivery
Umbilical arterial base excess
base excess of Umbilical ABGA (fetal outcome), mmol/L
Time frame: immediately after delivery
Umbilical arterial partial oxygen pressure (PO2)
partial oxygen pressure of Umbilical ABGA (fetal outcome), mmHg
Time frame: immediately after delivery
Umbilical arterial carbon dioxide partial pressure (PCO2)
carbon dioxide partial pressure of Umbilical ABGA (fetal outcome), mmHg
Time frame: immediately after delivery