The Effect of Some Parturients' Characteristics on Sensory Block Level After Spinal Anesthesia

Study Overview
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Brief Summary
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Although the exact mechanism remains unknown, the association of pregnancy and decreased local anesthetic requirement is clear. demonstrated that more local anesthetic is required for cesarean section under combined spinal-epidural anesthesia in preterm compared with term patients.

Detailed Description
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However, in pregnant patients, venous engorgement is prominent in the supine but not the lateral position, which suggests direct compression of the inferior vena cava by the gravid uterus. Second, an increase in intraabdominal pressure may affect the retroperitoneal area and may cause inward movement of soft tissue in the intervertebral foramina. Recent magnetic resonance imaging studies in pregnant patients, although without intraabdominal pressure measurements, suggested the latter because they showed limited contact of engorged veins along the dural sac which may therefore not be responsible for compression of the dura. If elevated intraabdominal pressure contributes to high anesthetic spread during pregnancy, one would expect a relationship between intraabdominal pressure and maximum sensory block level.

Official Title
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The Effect of Body Mass Index, Intra-abdominal Pressure, Abdominal Girth and Waist Circumference on Sensory Block Level After Single-shot Spinal Anesthesia for Cesarean Section

Conditions
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Anesthesia, Obstetrical

Intervention / Treatment
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* Drug: Bupivacaine Hydrochloride


Participation Criteria
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Eligibility Criteria
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Inclusion Criteria: adult female partner aged 18 to 40 years. scheduled for elective cesarean section. Exclusion Criteria: Patients with coagulopathy or under anti-coagulation therapy. Gastrointestinal disease, motion sickness. diabetes mellitus. Patients with preeclampsia,

Ages Eligible for Study
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Minimum Age: 18 Years
Maximum Age: 40 Years

Sexes Eligible for Study
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Female

Accepts Healthy Volunteers
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No

Study Plan
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How is the study designed?
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Design Details

Primary Purpose: Screening
Intervention Model: Single Group Assignment
Interventional Model Description: evaluating relationship of sensory level and other patient factors
Masking: None (Open Label)


Arms and Interventions

| Participant Group/Arm | Intervention/Treatment |
| --- | --- |
| Experimental: intrathecal bupivacaine<br>intrathecal bupivacaine hydrochloride 0.5%,12.5mg | Drug: Bupivacaine Hydrochloride<br>* intrathecal bupivacaine will be used for spinal anesthesia in obstetric patients undergoing C-section<br>* Other names: intrathecal bupivacaine;|

What is the study measuring?
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Primary Outcome Measures

| Outcome Measure | Measure Description | Time Frame |
| --- | --- | --- |
| sensory level | effect of different parameters in sensory level | from allocation until 24 hours post-operative | 
| motor block | effect of different parameters in motor level | from allocation until 24 hours post-operative | 

Secondary Outcome Measures

| Outcome Measure | Measure Description | Time Frame |
| --- | --- | --- |
| hypotension | incidence of hypotension after spinal anesthesia | from allocation until 24 hours post-operative | 
| vasopressor consumption | total dose of ephedrine consumed by the patients | from allocation until 24 hours post-operative |