Clinical trial NCT02633995: Spinal Anaesthesia and Severe Preeclampsia
Official title: Spinal Anesthesia in Severe Preeclampsia and Its Impact on Hemodynamics (Case Control Study)
Study type: OBSERVATIONAL
Overall status: UNKNOWN
Conditions: Preeclampsia
Lead sponsor: Kasr El Aini Hospital
Sponsor class: OTHER
First posted: 2015-12-17
Enrollment: 60
Sex: FEMALE
Minimum age (years): 18
Maximum age (years): 40
Standard ages: ADULT
Accepts healthy volunteers: no
Observational model: CASE_CONTROL
Time perspective: PROSPECTIVE
Sampling method: PROBABILITY_SAMPLE
Study population: two equal groups (n=30), Pregnant females with severe pre-eclampsia : (group A) and normotensive parturients (group B) presenting for full term delivery with caesarean section using spinal anesthesia at Kasr Al Aini hospital in the duration of 3 months from december 2015 to march 2016 will be included.

Brief summary: The use of spinal anesthesia in pre-eclamptic pregnant woman is of considerable benefit, as these patients present particular hazards with general anaesthesia, such as concerns for rapid airway control and cerebral blood flow alterations during induction of general anaesthesia and intubation However, the incidence of hypotension is high during spinal anesthesia for Cesarean section and it may approach values up to 95 %.

Detailed description: The parturient will be allocated into one of two equal groups (n=30), a severe preeclampsia group (A) and a normotensive group (B). All will receive colload (500 ml voluven) as a coload via wide bore (16 Gauge ) cannula within 5-10 minutes during induction of spinal anesthesia. Standard monitoring with electrocardiography, automated non-invasive arterial pressure (NIAP) measurement, and pulse oximetry will be performed. Systolic arterial pressure (SAP), mean arterial pressure (MAP) and diastolic arterial pressure (DAP) will be monitored. Baseline values will be recorded in the supine position. Central venous line will be inserted in severe preeclampsia group and central venous pressure will be measured every 10 minutes.

Spinal anesthesia will be induced with a total of 10 mg of 0.5% hyperbaric bupivacaine and 25 µg fentanyl (total volume 2.5 ml) at the L3-4 interspace in the sitting position then the patient will be returned immediately to the supine position with left lateral tilt.

Eligibility criteria: Inclusion Criteria:

* Age: 18 - 40 years
* Severely Pre-eclamptic females, severe pre-eclampsia is defined as hypertension( BP \> 159/109) ,proteinuria ( urinary protein excretion of greater than 5 gm per day) and oliguria(\<500 ml in 24 hours) with at least one maternal organ dysfunction .

Exclusion Criteria:

* Age : \<18 years
* Obese patients with BMI \> 35 Kg/m2
* Preterm delivery
* Patients with contraindication to spinal anesthesia.
* Patients in active labor

Primary outcomes:
measure: Percentage of participants showing significant hemodynamic changes in response to spinal anesthesia as detected by hemodynamic monitors (blood pressure, heart rate and oxygen saturation)
timeFrame: 3 months
Secondary outcomes:
measure: Percentage of participants showing short term adverse side effects in response to spinal anesthesia as nausea, vomiting and shivering
timeFrame: 3 months
Other outcomes:
Locations:
city: Cairo
country: Egypt
facility: Cairo University
Study officials:
affiliation: department of anaesthesia faculty of medicine cairo university
name: maher fawzy, m.d.
role: STUDY_DIRECTOR
affiliation: department of anaesthesia faculty of medicine cairo university
name: nisreen refaie, m.d.
role: STUDY_CHAIR
affiliation: department of anaesthesia faculty of medicine cairo university
name: ahmed elsakka, m.d.
role: STUDY_CHAIR
affiliation: department of anaesthesia faculty of medicine cairo university
name: mina helmy
role: PRINCIPAL_INVESTIGATOR
References: