The Effect of the Timing of Colloid and Crystalloid Infusions on Postspinal Hypotension After Spinal Anesthesia for Caesarian Section

Balikesir University

Status: Completed

Conditions: Complications; Anesthesia, Spinal and Epidural, in Pregnancy

Treatments: Other: Crystalloid Co-load; Other: colloid co-load; Other: Colloid Preload; Other: Crystalloid preload

Study type: Interventional

Funder types: Other

Identifiers

NCT02680678

BAU

Details and patient eligibility

About

Prevention of postspinal hypotension after spinal anesthesia for caesarian section by use of preoperative or intraoperative volume replacement. The comparison of crystalloid and colloid infusions and their timing via perfusion index and plethysmographic variability index.

Full description

To Prevent hypotension fluid replacement is usually used in pregnant patients scheduled for C/S. Different types of fluids can be used in order to achieve this. Also the timing of fluid replacement is important. In the present study patients were separated into 4 groups. Each receiving a one of two fluids in different times. ( Colloid pre-load, colloid co-load, crystalloid co-load and crystalloid pre-load.) The effect of overall hemodynamics and the incidence of hypotension are evaluated. Also peripheric monitors like perfusion index and plethysmographic variability index are evaluated for correlation.

Enrollment: 80 patients

Sex: Female

Ages: 18 to 50 years old

Volunteers: Accepts Healthy Volunteers

Inclusion criteria

• pregnant 37-41 weeks
• one fetus
• scheduled for C/S under spinal anesthesia
• accepting to participate

Exclusion criteria

• Emergency surgery
• placenta previa
• preeclampsia
• cardiovascular and cerebrovascular comorbidities
• morbid obesity (BMI>40)
• pregnancy weeks <36 and > 41
• The use of vasoconstrictors
• Severe Anemia ( Hb <9 g/dl)
• Refusal or known contraindication for spinal anesthesia

Trial design

Primary purpose: Prevention

Allocation: Randomized

Interventional model: Parallel Assignment

Masking: Triple Blind

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80 participants in 4 patient groups

Colloid preload

Active Comparator group

Description:

20 patients each patient receives 7 ml/kg of gelatin solution (gelofusin) 15 minutes before spinal anesthesia.

Treatment:

Other: Colloid Preload

Colloid Co-load

Active Comparator group

Description:

20 patients each patient receives 7 ml/kg of gelatin solution (gelofusin) beginning with spinal anesthesia.

Treatment:

Other: colloid co-load

Crystalloid Preload

Active Comparator group

Description:

20 patients each patient receives 20 ml/kg of Ringer's lactate solution 15 minutes before spinal anesthesia.

Treatment:

Other: Crystalloid preload

Crystalloid Co-load

Active Comparator group

Description:

20 patients each patient receives 20 ml/kg of Ringer's lactate solution beginning with spinal anesthesia.

Treatment:

Other: Crystalloid Co-load