The Effect of Different Altitude Levels on Spinal Anesthesia in Cesarean Section Surgery; Comparison of Anesthesia Parameters and Hemodynamic Changes
Phase: NA
Conditions: Pregnant, High Altitude
Sponsor: Giresun University

25.01.2023
The effect of different altitude levels on spinal anesthesia in cesarean 
section surgery; Comparison of anesthesia parameters and hemodynamic 
changes
DEMOGRAPHIC DATA;
Name surname
Age
Weight/Height/
BMI
(m-kg-kg/m2)
ASA
INTRAOPERATIVE FOLLOW-UP;
Basal
After 
Spinal 
3.minute
5.mn
10.mn
15.mn
30.mn
45.mn
60.m
n
HR (Heart rate)
MAP (mean 
arterial pressure)
mmHg
SpO2(Saturation)
Number and duration of spinal anesthesia 
applications
The value measured with a pH meter
Sensory block T6 transit time
Highest level of sensory block
MB (modified bromage) scale; time to reach score 1

MB (modified bromage) scale; time to reach score 2
MB (modified bromage) scale; time to reach score 3
Number of hypotensive episodes requiring 
ephedrine
Number of episodes of bradycardia requiring 
atropine
Number of episodes of nausea requiring Zofer
Surgery time
Anesthetic complications
POSTOPERATİF TAKİP;
1.hour
2.hour
3.hour
4.hour
5.hour
Sensory blockade end time
Motor blockade end time
Nausea-vomiting
Postdural puncture headache follow-up (YES/NO)
1.day
7.day
Modified bromage scale
0
 No paralysis, the patient can fully flex the foot and knee
1
Can only move knee and feet, can't lift leg straight
2
Can't flex knee, can only move foot
3
 He cannot move his foot joint or big toe, he has complete paralysis
Nausea-vomiting ‘Verbal Descriptive Scale’
0:
No nausea

1:
Mild nausea
2:
Moderate nausea
3:
One time vomiting
4:
Multiple vomiting
Study design
Standard noninvasive blood pressure, heart rate (HR), electrocardiogram (ECG) findings, 
peripheral oxygen saturation (SpO2) will be monitored for all patients brought to the 
operating room. 2.2 cc of bupivacaine will be administered after entering the L4-5 space 
under sterile conditions in the sitting position and seeing the cerebrospinal fluid flow. The 
shastaol will be quickly tilted laterally. Sensory block level will be checked with pinprick test 
and surgery will be started by recording the time to reach T6 dermatome. Mean arterial 
pressure, heart rate and peripheral oxygen saturation will be recorded before the procedure 
(baseline), at the 3rd, 5th, 10th, 15th, 30th, 45th and 60th minutes after the procedure. The 
number and duration of spinal anesthesia applications, the duration of sensory block 
formation in the T6 dermatome, the time to reach each score of the Modified bromage score 
scale, the operation time (the time from the beginning of the surgical incision to the 
completion of the surgery), the highest level of sensory block, and anesthetic complications 
will be recorded. Patients with a sensory block level below T6 in the recovery room and a 
Modified Aldrete score above 8 will be taken to the ward. During the postoperative period, 
sensory blockade time (time to feel the S2 dermatome), motor blockade time (time to have a 
MB score of 0) will be recorded every hour in the ward. Nausea and vomiting in the 
postoperative period will be followed up with the Verbal Descriptive Scale. On the first and 
seventh days after the operation, the patients will be questioned by the researcher for post-
dural puncture headache (PDPH, increased pain intensity when standing up from the supine 
position) by phone call.