Effect of Vasopressors on Spinal Anaesthesia Induced Hypotension
Condition: Spinal Anesthesia
MeSH terms: Hypotension
Study type: Interventional
Phase: Phase 4

Summary: 
      160 pregnant patients will be enrolled in this study. Participants will divide in to 4
      groups. Spinal anaesthesia will perform with 5% marcain heavy 2 ml+20 microgram fentanyl to
      the all patients. After performed spinal anaesthesia, vasopressor infusion will be started
      intravenously. Epinephrine will prepare 5 mg/ml and infusion rate will adjust 30 ml/h for
      Group E. Norepinephrine will prepare 5 mg/ml and infusion rate will adjust 30 ml/h for Group
      NE and 0.9% saline (group S) was launched immediately after induction of spinal anesthesia.
      Phenylephrine will prepare 100 microg/ml and infusion rate will adjust 30 ml/h for Group P.
      If systolic blood pressure decrease 20% of basal value or below to 100 mmHg, bolus ephedrine
      will apply intravenously (IV). If heart rate will decrease 60 beat per min or 20% of basal
      value, atropine will apply IV.
    

Detailed description: 
      After approved informed consent, 160 pregnant (term) patients with American society of
      anaesthesiologist (ASA) physiological status I-II will include this prospective, randomized
      clinical study. For randomisation of participants, computerized randomisation programme will
      use and they will divide into 4 groups. Basal value of systolic blood pressure(SBP) and heart
      rate (HR) will calculate with mean of the measure of 3 time SBP and HR before spinal
      anaesthesia. Spinal anaesthesia will perform with 5% marcain heavy 2 ml+20 microgram fentanyl
      at the point of lumbar 3-4 or 4-5 interspinous space to the all patients. After performed
      spinal anaesthesia, vasopressor infusion will start intravenously. Epinephrine,
      norepinephrine and phenylephrine will use for vasopressor infusion. Epinephrine will prepare
      5 mg/ml and infusion rate will adjust 30 ml/h for Group E. Norepinephrine will prepare 5
      mg/ml and infusion rate will adjust 30 ml/h for Group NE. Phenylephrine will prepare 100
      microg/ml and infusion rate will adjust 30 ml/h for Group P. salin infusion will launch 30
      ml/h for group Salin. If systolic blood pressure decrease 20% of basal value or below to 100
      mmHg, bolus ephedrine will apply intravenously (IV) for rescue drug. If heart rate will
      decrease 60 beat per min or 20% of basal value, atropine will apply IV.

      At the end of the study all collected data will use for statistically analysis.
    

Intervention name(s): Epinephrine; Norepinephrine; Phenylephrine; Saline
Intervention type(s): Drug; Drug; Drug; Drug
Intervention description(s): Epinephrine infusion rate will adjust 30 ml/h (5µg/ ml ); Norepinephrine infusion rate will adjust 30 ml/h (5µg/ ml ); Phenylephrine infusion rate will adjust 30 ml/h (100µg/ ml ); saline infusion will apply till the end of the surgery
Other intervention name(s): group I; group II; group III; group IV
Intervention MeSH terms: Phenylephrine; Epinephrine; Oxymetazoline; Norepinephrine
Allocation: Randomized
Intervention model: Parallel Assignment
Masking: Double (Participant, Care Provider)
Primary purpose: Prevention
Keywords: vasopressor; spinal anaesthesia