Changes in Cardiac Output During Cesarean Delivery Under Spinal Anesthesia

Mansoura University

Status

Completed

Conditions

Cesarean Section

Cardiac Output

Anesthesia, Spinal

Echocardiography

Treatments

Drug: Oxytocin

Procedure: Cesarean Delivery

Drug: Crystalloid Coload 1000 mL

Radiation: Transthoracic Echocardiography

Drug: Intrathecal Fentanyl

Drug: Intravenous Ephedrine

Drug: Intrathecal Bupivacaine

Procedure: Spinal Anesthesia

Study type

Observational

Funder types

Other

Identifiers

NCT05269537

MS.20.08.1232

Details and patient eligibility

About

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

Full description

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.

Enrollment

60 patients

Sex

Female

Ages

19 to 40 years old

Volunteers

No Healthy Volunteers

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)

Trial design

60 participants in 1 patient group

Study Group

Description:

Cardiac output will be measured at baseline using transthoracic echocardiography. Spinal anesthesia will be administered with injection of intrathecal bupivacaine and intrathecal fentanyl. Crystalloid coload 1000 mL will be administered: Ringer acetate 1000 mL will be administered over 10 minutes starting immediately after intrathecal injection. Cardiac output will be measured at 10 minutes after intrathecal injection, immediately after delivery, at 1 hour after intrathecal injection. Cesarean delivery will be performed. Intravenous ephedrine will be administered to correct hypotension. After delivery, 10 units of oxytocin in 500 ml Ringer acetate will be administered over 30 minutes.

Treatment: