Prediction of Spinal Anesthesia-Induced Hypotension in Cesarian Section: Carotid Artery-Corrected Flow Time Versus Cardiometry

Tanta University

Status: Completed

Conditions: Carotid Artery; Hypotension; Spinal Anesthesia; Cesarian Section; Corrected Flow Time; Cardiometry

Treatments: Other: Carotid Ultrasound; Other: Electrical cardiometry

Study type: Interventional

Funder types: Other

Identifiers

NCT06236217

34801/07/21

Details and patient eligibility

About

This research aimed to evaluate and compare the role of carotid corrected flow time (FTc) and electrical cardiometry (EC) in the prediction and prevention of post-spinal hypotension in elective cesarian section.

Full description

Spinal anesthesia is the procedure of choice for elective cesarean section (CS) because it avoids the most common side effects related to general anesthesia, such as the risk of aspiration, airway problems and the negative effects of intravenous anesthetic drugs on the fetus.

Accurate prediction of post-spinal hypotension could enhance clinical decision-making, optimize management, and facilitate early intervention. More than thirty predictors were used in the prediction of post-spinal hypotension including demographic data, hemodynamic variables, postural stress testing, peripheral perfusion indices, volume and fluid responsiveness indices, and genetic polymorphism.

The baseline parameters obtained via the bioreactance-based system may serve as a predictor of post-spinal anesthesia hypotension in parturient.

Enrollment: 300 patients

Sex: Female

Ages: 18+ years old

Volunteers: No Healthy Volunteers

Inclusion criteria

• Aged ≥ 18 years.
• American Society of Anesthesiologists (ASA) physical status II.
• Gestational age (GA) ≥ 36 weeks.
• Women planned elective cesarean section under spinal anesthesia.

Exclusion criteria

• Patient refusal to participate in the study.
• Gestational age of < 36 or ≥40 weeks of pregnancy.
• Pregnancy-induced hypertension.
• Diabetes.
• Cardiovascular diseases, arrhythmia.
• Antepartum hemorrhage.
• Body Mass Index (BMI) above 36 kg/m2.
• Clinical fetal complications.

Trial design

Primary purpose: Prevention

Allocation: Randomized

Interventional model: Parallel Assignment

Masking: None (Open label)

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300 participants in 3 patient groups

Control group

No Intervention group

Description:

Patients received standard of care with no intervention before spinal anesthesia.

Carotid Ultrasound group

Experimental group

Description:

The carotid artery corrected flow time (FTc) was used in patients to optimize the volume status before performing spinal anesthesia.

Treatment:

Other: Carotid Ultrasound

Electrical cardiometry group

Experimental group

Description:

Stroke volume variation (SVV) measured by electrical cardiometry (EC) was used to optimize the volume status before performing spinal anesthesia.

Treatment:

Other: Electrical cardiometry