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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.
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.
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| Label | Type | Description | Intervention Names |
|---|---|---|---|
| Colloid preload | Active Comparator | 20 patients each patient receives 7 ml/kg of gelatin solution (gelofusin) 15 minutes before spinal anesthesia. |
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| Colloid Co-load | Active Comparator | 20 patients each patient receives 7 ml/kg of gelatin solution (gelofusin) beginning with spinal anesthesia. |
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| Crystalloid Preload | Active Comparator | 20 patients each patient receives 20 ml/kg of Ringer's lactate solution 15 minutes before spinal anesthesia. |
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| Crystalloid Co-load | Active Comparator | 20 patients each patient receives 20 ml/kg of Ringer's lactate solution beginning with spinal anesthesia. |
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| Name | Type | Description | Arm Group Labels | Other Names |
|---|---|---|---|---|
| Colloid Preload | Other | preload infusion |
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| Measure | Description | Time Frame |
|---|---|---|
| Number of participants in each group who develop hypotension, and correlation between hypotension and Perfusion Index (PI) and Plethysmographic Variability Index (PVI) scores | Hypotension is going tobe measured in mmHG in 5 minute intervals and PI and PVI measurements are also recorded at the same time intervals. A decrease in blood presssure exceeding % 20 of the preoperative basal blood pressure measurement will be recorded as hypotension. The number of patients who develop hypotension will be recorded. Statistic difference will be avaluated between groups. Hypotensive episodes are going to be comparised with the PI and PVI measurements at the same time period and evaluation for correlation will be performed. | Measurements will be performed at 5 minute intervals beginning 15 minutes prior to the operation, throughout the whole operation untill the end. |
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Inclusion Criteria:
Exclusion Criteria:
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| Name | Affiliation | Role |
|---|---|---|
| Hafize Fisun Demir | Balikesir University School of Medicine Department of Anesthesia and Reanimation | Principal Investigator |
| Facility | Status | City | State | ZIP | Country | Contacts |
|---|---|---|---|---|---|---|
| Balikesir University Faculty of Medicine | Balıkesir | 10145 | Turkey (Türkiye) |
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4 group of patients were sheduled to receive either kristalloid or kolloid two gropus before and two groups during anesthesia induction
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the outcome accessor and care provider will be aware in which gropu the patient was
| colloid co-load | Other | co-load infusion |
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| Crystalloid preload | Other | preload infusion |
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| Crystalloid Co-load | Other | co-load infusion |
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| ID | Term |
|---|---|
| C060085 | succinylated gelatin |
| D000077325 | Ringer's Lactate |
| ID | Term |
|---|---|
| D000077324 | Crystalloid Solutions |
| D007552 | Isotonic Solutions |
| D012996 | Solutions |
| D004364 | Pharmaceutical Preparations |
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