Changes in Cardiac Output During Cesarean Delivery Under Spinal Anesthesia

Mansoura University60 enrolled

Overview

Cardiac output will be measured in healthy parturients undergoing cesarean delivery under spinal anesthesia

ASA-II women undergoing cesarean delivery under spinal anesthesia will be included. Cardiac output will be measured using transthoracic echocardiography at 4 time points: Baseline, after 10 minutes of intrathecal injection, after delivery, and after 1 hour of intrathecal injection. Spinal anesthesia will be administered with 2.5 ml bupivacaine 0.5% and fentanyl 15 μg.

Study Type

OBSERVATIONAL

Enrollment

Conditions

Anesthesia, Spinal Cesarean Section Echocardiography Cardiac Output

Interventions

Transthoracic EchocardiographyRADIATION

Measurement of cardiac output in supine position with left lateral tilt at baseline, at 10 minutes after intrathecal injection, immediately after delivery, and at 1 hour after intrathecal injection

Spinal AnesthesiaPROCEDURE

Performed at the L3-L4 or L4-L5 interspace using 25-gauge spinal needle

Intrathecal BupivacaineDRUG

Bupivacaine 12.5 mg (2.5 mL 0.5%) will be administered in the subarachnoid space

Eligibility

Sex: FEMALEMin age: 19 YearsMax age: 40 Years

Medical Language ↔ Plain English

Inclusion Criteria: * American Society of Anesthesiologists physical status II parturients. * Full term, singleton pregnancy * Elective cesarean delivery under spinal anesthesia Exclusion Criteria: * Height \<150 cm * Weight \<60 kg * Body mass index (BMI) \<18.5 or ≥ 35 kg/m² * Women presenting in labor * Contraindications to spinal anesthesia: increased intracranial pressure, coagulopathy, or local skin infection * Hemoglobin \<10 g/dL * Current administration of vasoactive drugs (e.g., salbutamol, thyroxin) * Diabetes mellitus, cardiovascular, or renal disease * Chronic or pregnancy-induced hypertension * Polyhydramnios * Women with high risk for postpartum hemorrhage or uterine atony (e.g., placenta accreta spectrum, ≥3 previous cesarean deliveries)

Locations (1)

Department of Anesthesia and Surgical Critical Care, Mansoura University Hospitals

Al Mansurah, Dakahlia Governorate, Egypt

Outcomes

Primary Outcomes

Changes in cardiac output

Cardiac output measured using transthoracic echocardiography

Time frame: At baseline, at 10 minutes after intrathecal injection, immediately after delivery, and at 1 hour after intrathecal injection

Secondary Outcomes

Changes in stroke volume

Time frame: At baseline, at 10 minutes after intrathecal injection, immediately after delivery, and at 1 hour after intrathecal injection

Changes in heart rate

Time frame: At baseline, at 10 minutes after intrathecal injection, immediately after delivery, and at 1 hour after intrathecal injection

Number of subjects requiring ephedrine