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The aim of this study was to compare between crystalloid versus crystalloid and colloid combination preloads for prevention of hypotension following intrathecal anaesthesia in patients undergoing elective Caesarean section.
To examine weather baseline perfusion index could predict the incidence of intrathecal-induced hypotension during Caesarean section.
Intrathecal anesthesia is the most commonly used technique for elective Caesarean section all over the world.
One of the most common complications of this technique is hypotension. It's incidence is more than 80% without any prophylactic measures, this hypotension has adverse effects on both mother ( causing nausea and vomiting ) and foetus ( causing acidosis and neurological defects ).
This complication can be managed by several ways like fluid therapy, usage of vasopressors or combination between both of them.
Among the type of fluids ( crystalloid or colloid ) it's still not known which one of them is better. Crystalloid has a short intravascular half-life because of its rapid distribution into the interstitial space. On the other hand colloid remains longer within the intravascular space.
Change in baseline peripheral vascular tone due to pregnancy may affect the degree of such hypotension. The perfusion index ( PI ) derived from a pulse oximeter has been used for assessing peripheral perfusion dynamics due to changes in peripheral vascular tone.
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| Label | Type | Description | Intervention Names |
|---|---|---|---|
| Ringer | Active Comparator | This group will receive 1 L of Ringer's solution as a preload |
|
| Voluven | Active Comparator | This group will receive 500 ml of 6% hydroxyethyl starch ( Voluven ) and 500 ml Ringer's solution as a preload |
|
| Name | Type | Description | Arm Group Labels | Other Names |
|---|---|---|---|---|
| Ringer | Drug | 1L of Ringer's solution as a preload in one group. |
|
| Measure | Description | Time Frame |
|---|---|---|
| Incidence of hypotension | Decrease in systolic blood pressure more than 20% of base line | 1 hour |
| Measure | Description | Time Frame |
|---|---|---|
| Perfusion index | Derived from pulse oximeter | 1 hour |
| Heart rate | 1 hour | |
| Urine output |
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Inclusion Criteria:
Exclusion Criteria:
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| Name | Role | Phone | Extension | |
|---|---|---|---|---|
| Essam E. Abd El-Hakeem, PhD | Contact | 01207159716 | Essam1993@yahoo.com | |
| Nagwa Mostafa Osman, PhD | Contact | 01006792219 | nagwaosman1962@yahoo.com |
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| PubMed Identifier | Type | Citation | Retractions |
|---|---|---|---|
| 25501602 | Background | Ripolles Melchor J, Espinosa A, Martinez Hurtado E, Casans Frances R, Navarro Perez R, Abad Gurumeta A, Calvo Vecino JM. Colloids versus crystalloids in the prevention of hypotension induced by spinal anesthesia in elective cesarean section. A systematic review and meta-analysis. Minerva Anestesiol. 2015 Sep;81(9):1019-30. Epub 2014 Dec 11. | |
| 15758080 |
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| ID | Term |
|---|---|
| D007022 | Hypotension |
| ID | Term |
|---|---|
| D014652 | Vascular Diseases |
| D002318 | Cardiovascular Diseases |
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| ID | Term |
|---|---|
| D000077324 | Crystalloid Solutions |
| C485123 | HES 130-0.4 |
| ID | Term |
|---|---|
| D007552 | Isotonic Solutions |
| D012996 | Solutions |
| D004364 | Pharmaceutical Preparations |
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| Voluven | Drug | 500 ml of voluven will be given in combination with 500 ml Ringer's solution as a preload in the other group. |
|
|
| 1 hour |
| Ngan Kee WD. Confidential enquiries into maternal deaths: 50 years of closing the loop. Br J Anaesth. 2005 Apr;94(4):413-6. doi: 10.1093/bja/aei069. No abstract available. |