The Role of Carotid Flow Time-Based Fluid Administration in Caesarean Section

The Role of Carotid Flow Time-Based Fluid Administration in the Incidence of Hypotension After Spinal Anesthesia in Patients Undergoing Caesarean Section

It has been reported that corrected carotid flow time (FTc) may indicate the responsiveness of spontaneously breathing patients to fluid therapy. The primary objective of the study is to determine the effect of fluid preload applied to patients with preanesthetic FTc values below the cut-off value on the incidence of hypotension in cesarean section (C/S) surgery. Pregnant women who underwent cesarean section under spinal anesthesia were included in this prospective study. In the preoperative care unit, patients were assigned to two groups according to their baseline FTc values. Patients with baseline FTc < 327 ms were assigned to the first group, and Ringer Lactate (RL) preload fluid administration to these patients was continued until FTc > 327 ms. On the other hand, patients with baseline FTc > 327 ms were assigned to the second group, and preload fluid was not administered to these patients. Intraoperative hemodynamic data were recorded for each patient.

Inclusion Criteria:

• 20-40 years of age pregnant women
• American Society of Anesthesiologists (ASA) physical status-II patients
• Uncomplicated, singleton, term pregnancy
• Elective C/S surgery

Exclusion Criteria:

• Placental disorders
• Gestational hypertensive disorders
• Morbid obesity (BMI>39 kg/m2)
• Carotid stenosis more than 50%
• Baseline SAP more than 160 mmHg
• Arrhythmia
• History of cardiovascular or cerebrovascular disease, and chronic kidney disease (estimated glomerular filtration rate <60 mL/min/1.73 m2)
• Emergency surgery