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Clinical Trial Details — Status: Completed

Administrative data

NCT number NCT05368415
Other study ID # Levo bolus in CS
Secondary ID
Status Completed
Phase Phase 4
First received
Last updated
Start date May 15, 2022
Est. completion date August 15, 2022

Study information

Verified date August 2022
Source Kasr El Aini Hospital
Contact n/a
Is FDA regulated No
Health authority
Study type Interventional

Clinical Trial Summary

Maternal hypotension after subarachnoid block is a frequent and deleterious complication during lower segment caesarean section (LSCS). Prophylaxis against hypotension using vasopressors had become a standard recommendation. In mothers with preeclampsia, post-spinal hypotension is less frequent compared to healthy mothers; thus, the latest guidelines do not recommend using vasopressors in preeclampsia patients unless there is a hypotensive episode . The incidence of post-spinal hypotension in mother with preeclampsia is nearly 25%. The commonly used vasopressors during CS are ephedrine, phenylephrine, and recently norepinephrine. The use of ephedrine is usually accompanied with maternal tachycardia and foetal acidosis. Phenylephrine (PE) had been the first line for prevention and management of maternal hypotension; however, its use in mothers with preeclampsia had not been adequately investigated. Thus, the best vasopressor for management of hypotension in mothers with preeclampsia is unknown. Norepinephrine (NE) is an alpha adrenergic agonist with weak beta adrenergic agonistic activity; thus, it does not cause significant cardiac depression as phenylephrine does. NE was introduced for use during CS with promising results when used as infusion and as boluses in healthy mothers . The use of NE boluses in management of hypotension in preeclamptic mothers was not adequately investigated. A dose 4 mcg NE was recently evaluated in preeclamptic mothers. In this study, we will compare 3 NE bolus doses (3 mcg, 4 mcg, and 5 mcg) in management of maternal hypotension after spinal block during CS in preeclamptic mothers.


Recruitment information / eligibility

Status Completed
Enrollment 60
Est. completion date August 15, 2022
Est. primary completion date August 1, 2022
Accepts healthy volunteers No
Gender Female
Age group 18 Years to 40 Years
Eligibility Inclusion Criteria: - pregnant female with preeclampsia - age 18-40 Exclusion Criteria: - age less than 18 - age above 40 - patient refusal of spinal anesthesia - patient with eclampsia - patient allergy to anesthesia drugs or to NE

Study Design


Intervention

Drug:
Norepinephrine
mothers will received NE bolus of 3,4 or 5 mcg for management of hypotension according to group allocation

Locations

Country Name City State
Egypt Cairo university, Kasr Alainy hospital Cairo

Sponsors (1)

Lead Sponsor Collaborator
Kasr El Aini Hospital

Country where clinical trial is conducted

Egypt, 

References & Publications (2)

Hasanin A, Amin S, Refaat S, Habib S, Zayed M, Abdelwahab Y, Elsayad M, Mostafa M, Raafat H, Elshall A, Fatah SAE. Norepinephrine versus phenylephrine infusion for prophylaxis against post-spinal anaesthesia hypotension during elective caesarean delivery: A randomised controlled trial. Anaesth Crit Care Pain Med. 2019 Dec;38(6):601-607. doi: 10.1016/j.accpm.2019.03.005. Epub 2019 Mar 30. — View Citation

Hassabelnaby YS, Hasanin AM, Adly N, Mostafa MMA, Refaat S, Fouad E, Elsonbaty M, Hussein HA, Mahmoud M, Abdelwahab YM, Elsakka A, Amin SM. Comparison of two Norepinephrine rescue bolus for Management of Post-spinal Hypotension during Cesarean Delivery: a randomized controlled trial. BMC Anesthesiol. 2020 Apr 17;20(1):84. doi: 10.1186/s12871-020-01004-y. — View Citation

Outcome

Type Measure Description Time frame Safety issue
Primary Neonatal concentration of HCO3 from a sample of umbilical cord as a surrogate of neonatal outcome measuring HCO3 from umbilical cord blood gases analysis up to 5 minutes after delivery
Secondary Rate of successful management of maternal hypotension defined as returned of SBP to be > 80% of the baseline reading in the next reading 2 minutes after administration of NE bolus 2 minutes after NE bolus
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