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Hypotension after spinal anesthesia is critical. Thus several interventions have been proposed to mitigate such effect.
Hypotension is a critical issue related to spinal anesthesia during cesarean delivery. Researchers of this study aimed to evaluate the impact of preoperative oral caffeine on the incidence of spinal hypotension during cesarean delivery.
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| Label | Type | Description | Intervention Names |
|---|---|---|---|
| Caffeine | Active Comparator | Patients will receive oral caffeine 200 mg before spinal anesthesia |
|
| Control group | Placebo Comparator | Will receive placebo before spinal anesthesia |
|
| Name | Type | Description | Arm Group Labels | Other Names |
|---|---|---|---|---|
| Caffeine (200 mg) | Drug | Oral caffeine will be given as 200 mg before spinal anesthesia |
| |
| Measure | Description | Time Frame |
|---|---|---|
| Incidence of spinal hypotension | Decrease systolic blood pressure < 20% of baseline value | After spinal anesthesia till delivery |
| Measure | Description | Time Frame |
|---|---|---|
| Time to first hypotensive episode | time to incidence of hypotension | after induction of spinal anesthesia |
| Incidence of severe hypotension | reduced systolic pressure < 60% of baseline value |
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Inclusion Criteria:
Exclusion Criteria:
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| Facility | Status | City | State | ZIP | Country | Contacts |
|---|---|---|---|---|---|---|
| Cairo University | Cairo | Cairo Governorate | 6890 | Egypt |
| PubMed Identifier | Type | Citation | Retractions |
|---|---|---|---|
| 28826374 | Result | Grosso G, Godos J, Galvano F, Giovannucci EL. Coffee, Caffeine, and Health Outcomes: An Umbrella Review. Annu Rev Nutr. 2017 Aug 21;37:131-156. doi: 10.1146/annurev-nutr-071816-064941. | |
| 40318850 | Result | Antar SS, Metaweh A, Neamatallah H, Abdelfattah M, Abdelbaser I, Awad KA. Preoperative oral caffeine as prophylaxis against post-spinal hypotension in patients undergoing orthopedic lower limb surgery: A randomized, placebo-controlled, double-blinded study. Anaesth Crit Care Pain Med. 2025 Aug;44(4):101537. doi: 10.1016/j.accpm.2025.101537. Epub 2025 May 1. |
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Individual Participant Data (IPD) will not be shared due to concerns regarding participant privacy and confidentiality. Although data may be de-identified, there remains a risk of re-identification, especially in studies involving small sample sizes or sensitive health information.
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| ID | Term |
|---|---|
| D002110 | Caffeine |
| ID | Term |
|---|---|
| D014970 | Xanthines |
| D000470 | Alkaloids |
| D006571 | Heterocyclic Compounds |
| D011688 | Purinones |
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| Placebo |
| Drug |
Patient at this arm will receive placebo |
|
| After onset of spinal anesthesia |
| APGAR score | APGAR score calculation at 5 minutes | at 5 minutes after delivery |
| Umbilical artery pH | Umbilical artery blood gases | At 5 minutes after delivery |
| 40550198 | Result | Helmy MA, Helmy KA, Kaddah RA, Shamma MA, Ali MA, Milad LM. Femoral artery Doppler as a novel predictor of spinal hypotension in elective cesarean delivery cases: a prospective observational study. Int J Obstet Anesth. 2025 Aug;63:104706. doi: 10.1016/j.ijoa.2025.104706. Epub 2025 Jun 18. |
| 39848332 | Result | Adolf Helmy M, Mansour M, Magdy Milad L, Mohammed Aboelregal E, Magdy Youssef M. Change in femoral artery pulsatility index as a novel predictor of post-spinal anesthesia hypotension in adult patients undergoing infra-umbilical surgeries: A prospective observational study. Anaesth Crit Care Pain Med. 2025 Apr;44(2):101482. doi: 10.1016/j.accpm.2025.101482. Epub 2025 Jan 21. No abstract available. |
| 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. |
| 41535923 | Derived | Helmy MA, Helmy KA, Zaki RM, Khatab SA, Embaby SA, Kaddah RA, Shamma MA, Milad LM. Caffeine before cesarean delivery: a novel preventive strategy against spinal hypotension, a double blind placebo-controlled trial. J Anesth Analg Crit Care. 2026 Jan 15;6(1):12. doi: 10.1186/s44158-025-00333-z. |
| D011687 |
| Purines |
| D006574 | Heterocyclic Compounds, 2-Ring |
| D000072471 | Heterocyclic Compounds, Fused-Ring |