Effects of Sedation on Spinal Anesthesia-induced Maternal Hypotension

• Status: Completed
• Trial end date: 2015-02-01
• Target enrollment: 0
• Participant gender: Female

Summary

Background: This study was designed to investigate the effect of sedation on the occurrence of maternal hypotension in preoperatively anxious parturients undergoing urgent category-1 Cesarean section (C/S) under spinal anesthesia.

Methods: After institutional ethics committee approval, prospectively collected data of 1824 parturients undergoing C/S were reviewed. Parturients with high preoperative anxiety scores (visual analogue scale for anxiety (VAS-A)≥70) undergoing C/S under spinal anesthesia with thiopental (Group S=49) and without any other type of sedation (Group NS=53) were included in the analysis. Hemodynamic parameters were documented and maximum systolic arterial pressure (SAP) reductions from the baseline after spinal anesthesia were calculated. Incidences of hypotension (SAP≥30% decrease from baseline or <100 mmHg) and bradycardia (HR<55 beats/min), and related-ephedrine and -atropine requirements were noted. Our primary endpoint was to compare the maximum SAP reductions from the baseline values in Groups S and NS. Secondary endpoints were incidences of hypotension and bradycardia, required ephedrine and atropine doses, newborn Apgar scores at 1st and 5th min.

• Accepts Healthy Volunteers?: Accepts Healthy Volunteers

Details

• Lead Sponsor: Van Training and Research Hospital
• Treatments: Anesthetics; Thiopental

Criteria

Inclusion Criteria:

• Urgent category-1 C/S

• ASA physical status I-II

• Aged between 18 and 35 years

• Term (≥37 weeks) singleton pregnancy

• BMI <40 kg/m2

• Height >150 cm or <180 cm

• High preoperative anxiety scores (visual analogue scale for anxiety (VAS-A) ≥70)

• Spinal anesthesia with thiopental sodium sedation

• Spinal anesthesia without any sedation

Exclusion Criteria:

• Preoperative prehydration

• Placenta previa

• Placenta accreta

• Hypertension

• Pregnancy-induced hypertension

• Urgent category ≥2

• General anesthesia

• Spinal anesthesia with sedation other than thiopental sodium