Comparison of Norepinephrine and Ephedrine on Hypotension After Spinal Anesthesia in Parturients
Study Details
Study Description
Brief Summary
Incidence of hypotension is high in parturients after spinal anesthesia. Ephedrine could be used to treat hypotension but lead to lower fetal pH as well. This study is to compare the effects of norepinephrine and ephedrine on hypotension in parturients.
Condition or Disease | Intervention/Treatment | Phase |
---|---|---|
N/A |
Detailed Description
Spinal anesthesia is an accepted technique in elective cesarean sections. However, hypotension, resulted from sympathectomy is a common problem, especially in pregnant women. Prevention of this complication by sympathomimetic agents is of potential clinical significance. Ephedrine could be used to treat hypotension but lead to lower fetal pH, which may be related to worse fetal outcome.Norepinephrine could improve the hypotension to the same extent as phenylephrine. In this study, we tend to compare the effects of norepinephrine and ephedrine on hypotension in parturients and on fetal acid status.
Study Design
Arms and Interventions
Arm | Intervention/Treatment |
---|---|
Experimental: norepinephrine norepinephrine is injected after spinal anesthesia |
Drug: Norepinephrine
norepinephrine injection
Other Names:
|
Other: ephedrine ephedrine is injected after spinal anesthesia |
Drug: Ephedrine
Ephedrine injection
Other Names:
|
Outcome Measures
Primary Outcome Measures
- incidence of hypotension [from immediately after spinal anesthesia to 30min after spinal anesthesia]
Secondary Outcome Measures
- pH value of fetal arterial blood [just after clamp of the umbilical cord, usually 1min to 10min after start of the surgery]
- incidence of nausea and vomiting [from immediately after spinal anesthesia to 30min after spinal anesthesia]
- incidence of dizzy [from immediately after spinal anesthesia to 30min after spinal anesthesia]
- incidence of chest congestion [from immediately after spinal anesthesia to 30min after spinal anesthesia]
- fetal arterial partial pressure of oxygen [just after clamp of the umbilical cord, usually 1min to 10min after start of the surgery]
- arterial base excess of fetal arterial blood [just after clamp of the umbilical cord, usually 1min to 10min after start of the surgery]
- lowest neonatal cerebral oxygen saturation [from clamp of the umbilical cord to 10 min later, 10min in total]
- lactate level of fetal arterial blood [just after clamp of the umbilical cord, usually 1min to 10min after start of the surgery]
- number of rescue vasoactive agent [from immediately after spinal anesthesia to 30min after spinal anesthesia]
- incidence of bradycardia [from immediately after spinal anesthesia to 30min after spinal anesthesia]
- incidence of dyspnea [from immediately after spinal anesthesia to 30min after spinal anesthesia]
- Apgar scores of the neonates [from clamp of umbilical cord to 1min after clamping]
The Apgar score is a method to quickly summarize the health of newborn children.It is determined by evaluating the newborn baby on five simple criteria(Appearance, Pulse, Grimace, Activity, Respiration) on a scale from zero to two, then summing up the five values thus obtained. The resulting Apgar score ranges from zero to 10. Scores 7 and above are generally normal; 4 to 6, fairly low; and 3 and below are generally regarded as critically low and cause for immediate resuscitative efforts
- Apgar scores of the neonates [from clamp of umbilical cord to 5min after clamping]
The Apgar score is a method to quickly summarize the health of newborn children.It is determined by evaluating the newborn baby on five simple criteria(Appearance, Pulse, Grimace, Activity, Respiration) on a scale from zero to two, then summing up the five values thus obtained. The resulting Apgar score ranges from zero to 10. Scores 7 and above are generally normal; 4 to 6, fairly low; and 3 and below are generally regarded as critically low and cause for immediate resuscitative efforts
Eligibility Criteria
Criteria
Inclusion Criteria:
- Patients scheduled for elective cesarean section
Exclusion Criteria:
-
Patients with severe pre-eclampsia
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Patients with contraindications for spinal anesthesia
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Patients with multiple pregnancy
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Patients with gestation <38w
Contacts and Locations
Locations
Site | City | State | Country | Postal Code | |
---|---|---|---|---|---|
1 | Xijing Hospital,Fourth Military Medical University | Xi'an | Shaanxi | China | 710032 |
Sponsors and Collaborators
- Air Force Military Medical University, China
Investigators
- Study Chair: Hailong DONG, Prof., Xijing Hospital
Study Documents (Full-Text)
None provided.More Information
Publications
- Carvalho B, Dyer RA. Norepinephrine for Spinal Hypotension during Cesarean Delivery: Another Paradigm Shift? Anesthesiology. 2015 Apr;122(4):728-30. doi: 10.1097/ALN.0000000000000602.
- Mitra JK, Roy J, Bhattacharyya P, Yunus M, Lyngdoh NM. Changing trends in the management of hypotension following spinal anesthesia in cesarean section. J Postgrad Med. 2013 Apr-Jun;59(2):121-6. doi: 10.4103/0022-3859.113840. Review.
- Moslemi F, Rasooli S. Comparison of Prophylactic Infusion of Phenylephrine with Ephedrine for Prevention of Hypotension in Elective Cesarean Section under Spinal Anesthesi: A Randomized Clinical Trial. Iran J Med Sci. 2015 Jan;40(1):19-26.
- XJH-A-2015-5-5-01