Spinal Anesthesia Clinical Trial
Official title:
Comparison of the Effect of Epinephrine, Norepinephrine and Phenylephrine on Spinal Anesthesia Induced Hypotension
160 pregnant patients will be enrolled in this study. Participants will divide in to 4 groups. Spinal anaesthesia will perform with 5% marcain heavy 2 ml+20 microgram fentanyl to the all patients. After performed spinal anaesthesia, vasopressor infusion will be started intravenously. Epinephrine will prepare 5 mg/ml and infusion rate will adjust 30 ml/h for Group E. Norepinephrine will prepare 5 mg/ml and infusion rate will adjust 30 ml/h for Group NE and 0.9% saline (group S) was launched immediately after induction of spinal anesthesia. Phenylephrine will prepare 100 microg/ml and infusion rate will adjust 30 ml/h for Group P. If systolic blood pressure decrease 20% of basal value or below to 100 mmHg, bolus ephedrine will apply intravenously (IV). If heart rate will decrease 60 beat per min or 20% of basal value, atropine will apply IV.
After approved informed consent, 160 pregnant (term) patients with American society of
anaesthesiologist (ASA) physiological status I-II will include this prospective, randomized
clinical study. For randomisation of participants, computerized randomisation programme will
use and they will divide into 4 groups. Basal value of systolic blood pressure(SBP) and heart
rate (HR) will calculate with mean of the measure of 3 time SBP and HR before spinal
anaesthesia. Spinal anaesthesia will perform with 5% marcain heavy 2 ml+20 microgram fentanyl
at the point of lumbar 3-4 or 4-5 interspinous space to the all patients. After performed
spinal anaesthesia, vasopressor infusion will start intravenously. Epinephrine,
norepinephrine and phenylephrine will use for vasopressor infusion. Epinephrine will prepare
5 mg/ml and infusion rate will adjust 30 ml/h for Group E. Norepinephrine will prepare 5
mg/ml and infusion rate will adjust 30 ml/h for Group NE. Phenylephrine will prepare 100
microg/ml and infusion rate will adjust 30 ml/h for Group P. salin infusion will launch 30
ml/h for group Salin. If systolic blood pressure decrease 20% of basal value or below to 100
mmHg, bolus ephedrine will apply intravenously (IV) for rescue drug. If heart rate will
decrease 60 beat per min or 20% of basal value, atropine will apply IV.
At the end of the study all collected data will use for statistically analysis.
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