Effect of Intra-abdominal Pressure to the Level of the Sensory Block at Caesarean Section Under Spinal Anesthesia

Study Overview
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Brief Summary
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It is known that an increase in intra-abdominal pressure (IAP) causes a decrease in the volume of cerebrospinal fluid in the lumbar and lower thoracic region, which may contribute to the development of more high spinal block.

Detailed Description
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There is a hypothesis, the higher the level of intra-abdominal pressure, the greater the likelihood of developing a high-level (=>Th4) sensor block.

Official Title
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Effect of Intra-abdominal Pressure to the Level of the Sensory Block at Caesarean Section Under Spinal Anesthesia

Conditions
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Obstetric Anesthesia Problems, High-Risk Pregnancy

Intervention / Treatment
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* Procedure: Measurement of IAP


Participation Criteria
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Eligibility Criteria
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Inclusion Criteria: Gestational age 36 - 40 weeks Singleton pregnancies Elective caesarean section Exclusion Criteria: Gestational age <= 35 weeks Twins pregnancies Disease the cardiovascular system (hypertension, etc.) Non-elective caesarean section
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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Design Details

Primary Purpose: Prevention
Intervention Model: Single Group Assignment
Masking: None (Open Label)


Arms and Interventions

| Participant Group/Arm | Intervention/Treatment |
| --- | --- |
| Experimental: Measurement of IAP<br>The data obtained are in inches of water column were translated in millimeters of mercury. | Procedure: Measurement of IAP<br>* The level of intra-abdominal pressure was measured via a Foley catheter through the urinary bladder. After the introduction of a 30 mL of warm saline. Measurement of the water column in the system was made from the zero level to the mid-axillary line, for 10 minutes, after quiet breathing pregnant at the time of expiration.<br>|

What is the study measuring?
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Primary Outcome Measures

| Outcome Measure | Measure Description | Time Frame |
| --- | --- | --- |
| The Level of Intra-abdominal Pressure (IAP) | Measurement of IAP: The level of intra-abdominal pressure was measured via a Foley catheter through the urinary bladder. After the introduction of a 30 mL of warm saline. Measurement of the water column in the system was made from the zero level to the mid-axillary line, after quiet breathing pregnant at the time of expiration. The data obtained are in inches of water column were translated in millimeters of mercury. | Before spinal anesthesia, average 10 minutes. | 
| Classification Grade of Intra-abdominal Hypertension (IAH) | Average IAP in pregnant women with different Grade of intra-abdominal hypertension Physiological norm (≤11,99 mm Hg) Grade I (12 - 15.99 mm Hg) Grade II (16 - 20.99 mm Hg) Grade III (21 - 25.99 mm Hg) | Before spinal anesthesia, average 10 minutes. | 
| Obesity and IAP | Effect of obesity on the level of IAP | Before spinal anesthesia, average 10 minutes. | 

Secondary Outcome Measures

| Outcome Measure | Measure Description | Time Frame |
| --- | --- | --- |
| Level of Sensory Blocks | Block level of thoracic vertebrae are reported for pregnant women who had level of sensory block higher than 4 thoracic vertebra and less than 5 thoracic vertebra | After spinal anesthesia, average 20 minutes. | 
| The Level of IAP | The level of IAP in obstetric patients in the groups with high ( => Th4) and low (< = Th5) blocks | After spinal anesthesia, average 20 minutes. | 
| Number of Pregnants With Blocks = > Th4 With IAP Higher or Less Than 16 mm Hg |  | After spinal anesthesia, average 20 minutes. |