Prediction of Hypotension Using Perfusion Index Following Spinal Anesthesia in Lower Segment Caesarean Section

NCT03319433 — Unknown, 130 participants, Paropakar Maternity and Women's Hospital

ClinicalTrials Daily  ·  Areas  ·  Conditions  ·  Drugs  ·  Sponsors  ·  
RegistryNCT03319433
StatusUnknown
Study typeObservational
Enrollment130 (Estimated)
SponsorParopakar Maternity and Women's Hospital (Other)
ConditionsSpinal, Hypotension, Perfusion Index
InterventionsPerfusion Index (Device)
Datesstart 2018-05-01 (estimated), primary completion 2018-08-30 (estimated), completion 2018-11-15 (estimated), first posted 2017-10-24, last updated 2018-04-11

Related Papers Related Patents Related Grants Related Experts
All trials for Spinal All trials for Hypotension All trials of Perfusion Index

-Summary

Spinal anesthesia for caesarean section is invariably associated with variable degree of hypotension. Hypotension that occurs may be detrimental to various organ system due to inadequate perfusion. Various methods and agents have been tried in order to address this problem. However, this calamity is far from over.

Perfusion index is one such attempt to address the problem of hypotension by predicting which group of parturient may develop hypotension. This is a type of non-invasive method of assessing the relative vascular tone with the use of pulse oximeter which calculates the ration of pulsatile versus the non-pulsatile component of the blood flow. During normal physiological changes in pregnancy, there is relative loss of vascular tone which predisposes this group of patient to sudden development of hypotension after the sympathetic block due to spinal anesthesia.

Thus, the aim of the study is to use the non-invasive perfusion index data to predict the occurrence of hypotension in a parturient so that helps us to guide fluid and other drug therapy to address the problem of hypotension.

Expand all sections  ·  Collapse all

+Arms and interventions

ArmTypeInterventionsDescription
Group I (Perfusion Index <3.5)Device: Perfusion IndexThose parturient with perfusion index <3.5 when baseline monitors are attached while the patient is being prepared for surgery.
Group II (Perfusion index >3.5)Device: Perfusion IndexThose parturient with perfusion index >3.5 when baseline monitors are attached while the patient is being prepared for surgery.
  • Perfusion Index (Device): Use of non-invasive pulse oximeter to determine perfusion index

+Outcome measures

Primary outcomes

  • Incidence of hypotension [3 months]: compare the incidence of hypotension following SAB for LSCS in parturient with or without a high perfusion index.

Secondary outcomes

  • Perfusion index [3 months]: To compare the perfusion index (PI) at various intervals between the two groups
  • Side-effects [3 months]: To study the profile of side effects between the two groups.
  • Systolic blood pressure [3 months]: To compare the systolic blood pressure (SBP) at various intervals between the two groups.
  • Diastolic blood pressure [3 months]: To compare the diastolic blood pressure (DBP) at various intervals between the two groups.
  • Mean arterial pressure [3 months]: To compare the mean arterial pressure (MAP) at various intervals between the two groups

+Eligibility

Sex: Female, ages: 20 Years to 35 Years

Inclusion Criteria:

1. ASA II physical status.
2. Planned for elective LSCS
3. Gestational age >36 weeks and <41 weeks

Exclusion Criteria:

1. Patient's refusal.
2. Emergency LSCS.
3. Patient's with contraindications to spinal anesthesia
4. Patient with BMI >40, preeclampsia, placenta praevia.
5. Patients with comorbidities like cerebrovascular or cardiovascular disease, and gestational diabetes.

+Publications

  • Results publication: Soma-Pillay P, Nelson-Piercy C, Tolppanen H, Mebazaa A. Physiological changes in pregnancy. Cardiovasc J Afr. 2016 Mar-Apr;27(2):89-94. doi: 10.5830/CVJA-2016-021. PMID 27213856
  • Results publication: Chooi C, Cox JJ, Lumb RS, Middleton P, Chemali M, Emmett RS, Simmons SW, Cyna AM. Techniques for preventing hypotension during spinal anaesthesia for caesarean section. Cochrane Database Syst Rev. 2017 Aug 4;8(8):CD002251. doi: 10.1002/14651858.CD002251.pub3. PMID 28976555
  • Results publication: Nag DS, Samaddar DP, Chatterjee A, Kumar H, Dembla A. Vasopressors in obstetric anesthesia: A current perspective. World J Clin Cases. 2015 Jan 16;3(1):58-64. doi: 10.12998/wjcc.v3.i1.58. PMID 25610851
  • Results publication: Duggappa DR, Lokesh M, Dixit A, Paul R, Raghavendra Rao RS, Prabha P. Perfusion index as a predictor of hypotension following spinal anaesthesia in lower segment caesarean section. Indian J Anaesth. 2017 Aug;61(8):649-654. doi: 10.4103/ija.IJA_429_16. PMID 28890560