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Regional anesthesia, including epidural, spinal and combined epidural spinal anesthesia (CSEA), is a pivotal part in modern anesthesiology. Previously, the investigators found that epidural and spinal anesthesia during cesarean section possesses different responsiveness to fluid (including crystalloid and colloid) management given prior or posterior to anesthesia. Although CSEA is also widely used as an alternative of single epidural or spinal anesthesia for its combined effect of fast onset of anesthesia of spinal anesthesia and the property of duration of epidural catheterization, the fluid resuscitation during CSEA is still unknown. The investigators hypothesized that fluid management during CSEA would produce different effect on hemodynamics in cesarean section compared with epidural and spinal anesthesia.
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| Label | Type | Description | Intervention Names |
|---|---|---|---|
| Prior crystalloid | Active Comparator | Crystalloid (Ringer's Lactate) was given before CSEA |
|
| Posterior crystalloid | Active Comparator | Crystalloid (Ringer's Lactate) was given after CSEA |
|
| Prior colloid | Active Comparator | Colloid (6% hydroxyethyl starch) was given before CSEA |
|
| Posterior colloid | Active Comparator | Colloid (6% hydroxyethyl starch) was given after CSEA |
|
| Name | Type | Description | Arm Group Labels | Other Names |
|---|---|---|---|---|
| Ringer's Lactate | Drug | Ringer's Lactate 8 ml/kg was given intravenously before or after CSEA in cesarean section |
|
| Measure | Description | Time Frame |
|---|---|---|
| Rate of hypotension | Anesthesia begin (0 min) to 120 min after anesthesia |
| Measure | Description | Time Frame |
|---|---|---|
| Recurrence of hypotension after ephedrine or phenylephrine | Anesthesia begin (0 min) to 120 min after anesthesia | |
| Consumption of ephedrine and phenylephrine | Anesthesia begin (0 min) to 120 min after anesthesia |
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Inclusion Criteria:
Exclusion Criteria:
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| Name | Affiliation | Role |
|---|---|---|
| XiaoFeng Shen, MD | Nanjing Medical University | Study Chair |
| Facility | Status | City | State | ZIP | Country | Contacts |
|---|---|---|---|---|---|---|
| The Affiliated Nanjing Maternity and Child Health Care Hospital | Nanjing | Jiangsu | 210004 | China |
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| ID | Term |
|---|---|
| D000077325 | Ringer's Lactate |
| ID | Term |
|---|---|
| D000077324 | Crystalloid Solutions |
| D007552 | Isotonic Solutions |
| D012996 | Solutions |
| D004364 | Pharmaceutical Preparations |
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|
| Six percent hydroxyethyl starch | Drug | Hydroxyethyl starch (6%) was given before or after CSEA in cesarean section |
|
|
| Total volume of colloid or crystalloid | Fifteen minutes before anesthesia to 120 min after anesthesia |
| One-min and 5-min Apgar scores | The first and fifth minute after cesarean successful delivery |
| Oxygen saturation during hypotension | Anesthesia begin (0 min) to 120 min after anesthesia |
| Duration of hypotension | Anesthesia begin (0 min) to 120 min after anesthesia |
| Low umbilical cord pH (artery < 7.20) | At the time of successful delivery (0 min) |