Spinal Anaesthesia and Severe Preeclampsia

Kasr El Aini Hospital

Status: Unknown

Conditions: Preeclampsia

Treatments: Procedure: spinal anaesthesia

Study type: Observational

Funder types: Other

Identifiers

NCT02633995

Mina

Details and patient eligibility

About

The use of spinal anesthesia in pre-eclamptic pregnant woman is of considerable benefit, as these patients present particular hazards with general anaesthesia, such as concerns for rapid airway control and cerebral blood flow alterations during induction of general anaesthesia and intubation However, the incidence of hypotension is high during spinal anesthesia for Cesarean section and it may approach values up to 95 %.

Full description

The parturient will be allocated into one of two equal groups (n=30), a severe preeclampsia group (A) and a normotensive group (B). All will receive colload (500 ml voluven) as a coload via wide bore (16 Gauge ) cannula within 5-10 minutes during induction of spinal anesthesia. Standard monitoring with electrocardiography, automated non-invasive arterial pressure (NIAP) measurement, and pulse oximetry will be performed. Systolic arterial pressure (SAP), mean arterial pressure (MAP) and diastolic arterial pressure (DAP) will be monitored. Baseline values will be recorded in the supine position. Central venous line will be inserted in severe preeclampsia group and central venous pressure will be measured every 10 minutes.

Spinal anesthesia will be induced with a total of 10 mg of 0.5% hyperbaric bupivacaine and 25 µg fentanyl (total volume 2.5 ml) at the L3-4 interspace in the sitting position then the patient will be returned immediately to the supine position with left lateral tilt.

Enrollment: 60 estimated patients

Sex: Female

Ages: 18 to 40 years old

Volunteers: No Healthy Volunteers

Inclusion criteria

• Age: 18 - 40 years
• Severely Pre-eclamptic females, severe pre-eclampsia is defined as hypertension( BP > 159/109) ,proteinuria ( urinary protein excretion of greater than 5 gm per day) and oliguria(<500 ml in 24 hours) with at least one maternal organ dysfunction .

Exclusion criteria

• Age : <18 years
• Obese patients with BMI > 35 Kg/m2
• Preterm delivery
• Patients with contraindication to spinal anesthesia.
• Patients in active labor

Trial design

60 participants in 2 patient groups

preeclampsia

Description:

spinal anaesthesia will be given for cesarean section

Treatment:

Procedure: spinal anaesthesia

normotensive

Description:

spinal anaesthesia will be given for cesarean section

Treatment:

Procedure: spinal anaesthesia