Not provided
Not provided
Not provided
Not provided
Not provided
Not provided
Not provided
Not provided
Not provided
Not provided
Not provided
Not provided
Not provided
Not provided
Not provided
Not provided
Not provided
In this study, we will investigate the effect of left lateral tiling performed after spinal block on maternal hemodynamics compared to ordinary supine position
Maternal hypotension is a common complication after spinal anesthesia for cesarean delivery (CD). Aortocaval compression is one of the theoretical mechanisms precipitating for post-spinal hypotension (PSH) for CD. Positioning of the patients in the left lateral tilted position after preforming spinal block was frequently considered a standard protocol for minimizing aortocaval compression and improve maternal hemodynamics during CD; however, the latest Cochrane database review reported that there is no adequate evidence to support any positioning protocol for prevention of PSH. Moreover, a recent study was conducted in full term pregnant women reporting no improvement in cardiac output with left lateral tilting. In this study, the effect of left lateral tiling performed after spinal block on maternal hemodynamics will be compared to ordinary supine position.
Not provided
Not provided
Not provided
Not provided
Not provided
| Label | Type | Description | Intervention Names |
|---|---|---|---|
| supine position | Placebo Comparator | the patient will receive spinal anesthesia by Bupivacaine; then she will be placed in supine position |
|
| Left lateral tilted position | Experimental | the patient will receive spinal anesthesia by Bupivacaine; then she will be placed in left lateral tilted position |
|
| Name | Type | Description | Arm Group Labels | Other Names |
|---|---|---|---|---|
| supine position | Other | the patient will be placed in regular supine position after spinal anesthesia |
|
| Measure | Description | Time Frame |
|---|---|---|
| postspinal hypotension | The number of patients who develop hypotension (defined as decreased SBP less than 80% of the baseline reading during the period from intrathecal injection till delivery of the fetus) after spinal block divided by the total number in the group | 30 minutes after spinal anesthesia |
| Measure | Description | Time Frame |
|---|---|---|
| severe postspinal hypotension | The number of patients who develop hypotension (defined as decreased SBP less than 60% of the baseline reading during the period from intrathecal injection till delivery of the fetus) after spinal block divided by the total number in the group | 30 minutes after spinal anesthesia |
Not provided
Inclusion Criteria:
Exclusion Criteria:
Not provided
Not provided
Not provided
Not provided
| Name | Role | Phone | Extension | |
|---|---|---|---|---|
| Ahmed Shash, Professor | Contact | +201001033999 | shashahmed@gmail.com |
| Name | Affiliation | Role |
|---|---|---|
| Ahmed Mukhtar, Professor | Head of research committee section in anesthesia department | Study Chair |
| Facility | Status | City | State | ZIP | Country | Contacts |
|---|---|---|---|---|---|---|
| Cairo University | Recruiting | Cairo | Egypt |
Not provided
Not provided
Not provided
Not provided
Not provided
Not provided
| ID | Term |
|---|---|
| D016683 | Supine Position |
| D002045 | Bupivacaine |
| ID | Term |
|---|---|
| D011187 | Posture |
| D009142 | Musculoskeletal Physiological Phenomena |
| D055687 | Musculoskeletal and Neural Physiological Phenomena |
| D000813 | Anilides |
Not provided
Not provided
Not provided
Not provided
Not provided
Not provided
| left lateral tilted position | Other | the patient will be placed in left lateral tilted position after spinal anesthesia |
|
| Bupivacaine | Drug | The patient will receive 10 mg Bupivacaine for spinal anesthesia |
|
|
| Post-delivery hypotension |
number of patients who develop hypotension (defined as decreased SBP less than 80% of the baseline reading after delivery of the fetus and starting oxytocin infusion |
| 10 minutes after delivery |
| systolic blood pressure | systolic blood pressure measured in mmHg | 60 minutes after spinal block |
| diastolic blood pressure | diastolic blood pressure measured in mmHg | 60 minutes after spinal block |
| heart rate | heart rate measured in beats per minute | 60 minutes after spinal block |
| incidence of nausea and vomiting | number of patients who develop nausea and vomiting divided by the total number of patients in the group | 60 minutes after spinal block |
| ephedrine consumption | total amount of ephedrine consumed during the operation (measured in milligrams) | 60 minutes after spinal block |
| Atropine consumption | total amount of atropine consumed during the operation (measured in milligrams | 60 minutes after spinal block |
| APGAR score | APGAR score for detection of the well being of the fetus | 1 minute after delivery |
| APGAR score | APGAR score for detection of the well being of the fetus | 10 minute after delivery |
| D000577 | Amides |
| D009930 | Organic Chemicals |
| D000814 | Aniline Compounds |
| D000588 | Amines |