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Spinal anesthesia is a widely chosen technique in obstetric theaters due to several advantages, however sympathetic block results in hypotension that carry several consequences on maternal and fetal health, thus early prediction and management takes high priority. in this regards recent recommendations suggest the use of prophylactic vasopressors like noradrenaline, researchers of this study aimed to explore the impact of leg elevation on prophylactic noradrenaline dose
after spinal anesthesia, patients will be randomly allocated into 2 groups : Leg elevation group and control group.
noradrenaline will be used as variable infusion starting from 0.05 microgram/kg/min up to 0.14 microgram /kg/minute.
noradrenaline infusion will be continued till delivery of the baby
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| Label | Type | Description | Intervention Names |
|---|---|---|---|
| Leg elevation group | Experimental | leg will be elevated 30 degrees immediately after spinal anesthesia |
|
| Control group | No Intervention | Legs will remain supine after spinal anesthesia |
| Name | Type | Description | Arm Group Labels | Other Names |
|---|---|---|---|---|
| Leg elevation | Device | leg will be raised 30 degrees after spinal anesthesia using standardized pillow |
|
| Measure | Description | Time Frame |
|---|---|---|
| Average noradrenaline requirements | average noradrenaline requirements in both groups (mcg/kg/min) | baseline to delivery of the baby |
| Measure | Description | Time Frame |
|---|---|---|
| Total noradrenaline requirements | baseline to delivery | |
| incidence of spinal hypotension | baseline to delivery | |
| incidence of severe hypotension |
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Inclusion Criteria:
Exclusion Criteria:
Pregnant women undergoing elective ceserean section
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| Facility | Status | City | State | ZIP | Country | Contacts |
|---|---|---|---|---|---|---|
| Cairo University | Cairo | Giza Governorate | 6890 | Egypt |
| PubMed Identifier | Type | Citation | Retractions |
|---|---|---|---|
| 28438121 | Result | Hasanin A, Aiyad A, Elsakka A, Kamel A, Fouad R, Osman M, Mokhtar A, Refaat S, Hassabelnaby Y. Leg elevation decreases the incidence of post-spinal hypotension in cesarean section: a randomized controlled trial. BMC Anesthesiol. 2017 Apr 24;17(1):60. doi: 10.1186/s12871-017-0349-8. | |
| 39047530 | Result | Lyu W, Zhang Z, Li C, Wei P, Feng H, Zhou H, Zheng Q, Zhou J, Li J. Intravenous initial bolus during prophylactic norepinephrine infusion to prevent spinal hypotension for cesarean delivery: A randomized controlled, dose-finding trial. J Clin Anesth. 2024 Oct;97:111562. doi: 10.1016/j.jclinane.2024.111562. Epub 2024 Jul 23. |
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Data will be available from corresponding author upon reasonable request
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| baseline to delivery |
| 30335625 | Result | Hasanin AM, Amin SM, Agiza NA, Elsayed MK, Refaat S, Hussein HA, Rouk TI, Alrahmany M, Elsayad ME, Elshafaei KA, Refaie A. Norepinephrine Infusion for Preventing Postspinal Anesthesia Hypotension during Cesarean Delivery: A Randomized Dose-finding Trial. Anesthesiology. 2019 Jan;130(1):55-62. doi: 10.1097/ALN.0000000000002483. |
| 29090733 | Result | Kinsella SM, Carvalho B, Dyer RA, Fernando R, McDonnell N, Mercier FJ, Palanisamy A, Sia ATH, Van de Velde M, Vercueil A; Consensus Statement Collaborators. International consensus statement on the management of hypotension with vasopressors during caesarean section under spinal anaesthesia. Anaesthesia. 2018 Jan;73(1):71-92. doi: 10.1111/anae.14080. Epub 2017 Nov 1. No abstract available. |
| 34034957 | Result | Yu C, Gu J, Liao Z, Feng S. Prediction of spinal anesthesia-induced hypotension during elective cesarean section: a systematic review of prospective observational studies. Int J Obstet Anesth. 2021 Aug;47:103175. doi: 10.1016/j.ijoa.2021.103175. Epub 2021 May 1. |
| 41152963 | Derived | Helmy MA, Naguib NN, Helmy KA, Milad LM. The influence of thirty-degree leg elevation on noradrenaline requirements administered as a prophylactic variable infusion during cesarean delivery, an open-label randomized controlled trial. J Anesth Analg Crit Care. 2025 Oct 28;5(1):73. doi: 10.1186/s44158-025-00290-7. |