Spinal Anaesthesia for Caesarean Section: Descriptive Multicentre Study

Study Overview
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Brief Summary
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Most of caesarean sections can be performed under spinal anaesthesia. Its major advantages are reliability and fast onset. However, dose of hyperbaric bupivacaine used, combination with adjuvants, hemodynamic management, and impact of these measures on maternal experience are not uniform. This study aims to describe practices of spinal anaesthesia for caesarean section in France to improve practices, guide new studies and establish protocols.

Detailed Description
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Most of caesarean sections can be performed under spinal anaesthesia. Its major advantages are reliability and fast onset. However, techniques of spinal anaesthesia are varied. Dose of hyperbaric bupivacaine used may shifted, varying intensity of sensor block but also hemodynamic side effect. Likewise, use of adjuvant is frequent and differs between centres. Management of the maternal hemodynamic is also discussed. While it is recognized that intraoperatively vascular filling alone is not effective, use of vasopressors is not unequivocal. For example, recent studies support the use of norepinephrine. Finally, maternal experience is a hot topic. Although insufficient anaesthesia is rare, it is often overlooked. There are few recommendations on the intraoperative treatment of insufficient anaesthesia and to the management of post-traumatic stress that it lead to. The objective of this study is to describe practices of spinal anaesthesia for scheduled or non-emergency caesarean section (also named green code) in France by detailing several points: Technique of spinal anaesthesia: The anaesthesia solution used (doses and adjuvants) Management of hemodynamic Management of insufficient anaesthesia Maternal experience It aims to make an inventory of practices, to orient future studies, guide practice and the realization of protocols. It is an observational study unfolds from 2021 to 2022. It concerns 11 French centres and 600 women. Data are collected with an online questionnaire.

Official Title
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Spinal Anaesthesia for Caesarean Section: Descriptive Multicentre Study

Conditions
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Anesthesia, Spinal, Nonemergency Cesarean Section

Intervention / Treatment
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* Procedure: Spinal anaesthesia for caesarean section


Participation Criteria
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Eligibility Criteria
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Inclusion Criteria: Age ≥ 18 years old Affiliation to social security system Scheduled or elective Caesarean section (green code) under spinal anesthesia Exclusion Criteria: Refusal to participate in the study Code red Caesarean section or general anesthesia decision Complicated Caesarean section or combined spinal-epidural technique Presence of an epidural catheter Performing a combined spinal-epidural technique (even if the epidural catheter is not used) Contraindication to spinal anaesthesia (coagulation disorder, vertebral-medullary pathologies) Patient under guardianship or curatorship

Ages Eligible for Study
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Minimum Age: 18 Years

Sexes Eligible for Study
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Female

Accepts Healthy Volunteers
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Accepts Healthy Volunteers

Study Plan
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How is the study designed?
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Arms and Interventions

| Participant Group/Arm | Intervention/Treatment |
| --- | --- |
| Usual pratice<br>Assessment of usual practices | Procedure: Spinal anaesthesia for caesarean section<br>* Descriptive questionnaire with open and closed questions, to be completed during the procedure<br>|

What is the study measuring?
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Primary Outcome Measures

| Outcome Measure | Measure Description | Time Frame |
| --- | --- | --- |
| Maternal data | Ad hoc Questionnaire | Day of surgery | 
| Obstetrical data | Ad hoc Questionnaire | Day of surgery | 
| Spinal procedure | Ad hoc Questionnaire | Day of surgery | 
| Haemodynamic management | Ad hoc Questionnaire | Day of surgery | 
| Maternal experience | Ad hoc Questionnaire | Day of surgery | 

 Terms related to the study
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Keywords Provided by Centre Hospitalier Valida
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Anaesthesia, Spinal, Caesarean Section, Hyperbaric bupivacaine, Hemodynamic management after spinal anaesthesia, Maternal experience