Intra-abdominal Pressure, Abdominal Circumference, and Spinal Block Level in Cesarean Section

Kutahya Health Sciences University107 enrolled

Overview

Spinal anesthesia is commonly used for cesarean section and provides effective anesthesia with rapid onset. However, the spread of spinal anesthesia may vary among pregnant women due to physiological and anatomical changes during pregnancy. Increased intra-abdominal pressure and abdominal circumference may influence cerebrospinal fluid dynamics and affect the level of sensory block achieved after spinal anesthesia. This prospective observational study aims to evaluate the relationship between intra-abdominal pressure, abdominal circumference, and the maximum sensory block level following spinal anesthesia in pregnant women undergoing cesarean section. Intra-abdominal pressure and abdominal circumference will be measured before surgery, and sensory block levels and hemodynamic parameters will be assessed after spinal anesthesia. The findings of this study may help to better understand factors affecting spinal block spread in pregnant patients.

Study Type

OBSERVATIONAL

Enrollment

107

Conditions

Cesarean Section Pregnancy Elective Cesarean Section

Eligibility

Sex: FEMALEMin age: 18 YearsMax age: 40 Years

Medical Language ↔ Plain English

Inclusion Criteria: * Pregnant women aged 18-40 years * Scheduled for elective cesarean section at Kütahya City Hospital * Planned spinal anesthesia * ASA physical status II-III * Provided written informed consent Exclusion Criteria: * Refusal to participate in the study * Emergency cesarean section * Preeclampsia or other hypertensive disorders of pregnancy * Onset of labor or premature rupture of membranes * Clinical conditions affecting intra-abdominal pressure, including peripheral edema or ascites * Height \<140 cm or \>180 cm * Body mass index \< 40 kg/m² * Spinal deformity or history of spinal surgery * Contraindications to neuraxial anesthesia * Known allergy to bupivacaine * Requirement for additional surgical procedures other than cesarean section * Conditions contraindicating or interfering with intra-abdominal pressure measurement, including active or previous postdural puncture headache, neurogenic bladder, hematuria, or incidental abdominal mass

Outcomes

Primary Outcomes

Maximum sensory block level after spinal anesthesia

The maximum dermatomal level of sensory block assessed by loss of cold sensation after spinal anesthesia.

Time frame: Within the first 30 minutes after spinal anesthesia

Secondary Outcomes

Intra-abdominal pressure

Intra-abdominal pressure measured in the preoperative period before spinal anesthesia and in the postoperative period following cesarean section using an intravesical measurement technique.

Time frame: Baseline (preoperative, before spinal anesthesia) and early postoperative period (within 30 minutes after cesarean section)

Abdominal circumference

Abdominal circumference measured at the level of the umbilicus before spinal anesthesia and in the postoperative period following cesarean section.

Time frame: Baseline (preoperative, before spinal anesthesia) and early postoperative period (within 30 minutes after cesarean section)

Incidence of hypotension after spinal anesthesia

Hypotension defined as mean arterial pressure \<65 mmHg measured during the first 30 minutes after spinal anesthesia.

Time frame: Within the first 30 minutes after spinal anesthesia

Vasopressor requirement

Requirement and total dose of vasopressor agents administered after spinal anesthesia.

Time frame: Perioperative period