Manging Post Spinal Hypotension During Elective Cesarean Section

• Status: Completed
• Trial end date: 2018-12-31
• Target enrollment: 0
• Participant gender: Female

Summary

Spinal anesthesia is the gold standard technique for elective cesarean section. It helps to avoid risks regarding airway management and provides effective neuraxial postoperative analgesia, enabling quicker maternal recovery. Cesarean section normally require an anesthetic block at T4 level. So that maternal hypotension is reported to occur in up to 80%. This can result in significant morbidity for both the mother and fetus.The purpose of this study is to determine if epinephrine is as effective and safe compared to ephedrine for maintaining arterial blood pressure during elective cesarean section under spinal anesthesia. All participants will receive spinal anesthesia with a local anesthetic and sufentanil. This study plans to enroll 140 healthy pregnant women. Patients will be randomly assigned according to a computer generated system to be in one of two groups.

• Phase: Phase 4
• Accepts Healthy Volunteers?: Accepts Healthy Volunteers

Details

• Lead Sponsor: Ben marzouk Sofiene
• Treatments: Anesthetics; Ephedrine; Epinephrine; Epinephryl borate; Pseudoephedrine; Racepinephrine

Criteria

Inclusion Criteria:

• ASA II

• BMI>18 and <35 Kg/m2

• full term parturients with singleton pregnancy

• scheduled of elective cesarean section under spinal anesthesia

Non-inclusion criteria:

• Patient refusal.

• ASA > II

• Preexisting or pregnancy-induced hypertension

• The use of cardiac medication or medication for BP control.

• Cardiovascular or cerebrovascular disease.

• Multiple pregnancy.

• Suspicion of abnormal placentation.

• Known fetal abnormalities or fetal distress.

• CS under general anesthesia.

• Active labor.

• Emergency.

• Allergy to any of the medications used in the study.

Exclusion Criteria:

• Hemodynamic instability that is not in relationship with SA (occurrence of a surgical per-operative complication e.g. bleeding by placental insertion abnormality or a uterine atony).

• An abnormal extension of the anesthetic block defined as a sensory block level > D4.

• SA failure.

• The need to convert to general anesthesia.