Impact of pre-spinal atropine on post spinal hemodynamic and cardiac output measured by electrical cardiometry in cesarean delivery, a randomized controlled trial

ABSTRACTBackground Spinal anesthesia is a widely used technique for cesarean delivery, but it often results in hypotension, bradycardia, and reduced cardiac output (CO). Atropine has a potent muscarinic receptor antagonist activity in the heart. It may be a good choice to prevent post-spinal bradyca...

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Main Authors: Amin M. Alansary, Mohamed Mourad Ali, Minatallah Ali Elshafie
Format: Article
Language:English
Published: Taylor & Francis Group 2023-12-01
Series:Egyptian Journal of Anaesthesia
Subjects:
Online Access:https://www.tandfonline.com/doi/10.1080/11101849.2023.2236866
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author Amin M. Alansary
Mohamed Mourad Ali
Minatallah Ali Elshafie
author_facet Amin M. Alansary
Mohamed Mourad Ali
Minatallah Ali Elshafie
author_sort Amin M. Alansary
collection DOAJ
description ABSTRACTBackground Spinal anesthesia is a widely used technique for cesarean delivery, but it often results in hypotension, bradycardia, and reduced cardiac output (CO). Atropine has a potent muscarinic receptor antagonist activity in the heart. It may be a good choice to prevent post-spinal bradycardia and minimize the marked CO reduction.Methods Sixty pregnant women between the ages of 18 and 40 who were ASA-PS II and planned for elective cesarean delivery were divided into two equal groups at random. Both groups received spinal anesthesia. Atropine group (I) (n = 30): patients received 0.01 mg/kg atropine, while control group (II) (n = 30): patients received the same volume of saline. CO measured by electrical cardiometry (EC) was the primary outcome where, heart rate (HR), mean blood pressure (MBP), stroke volume (SV), systemic vascular resistance (SVR), and neonatal outcomes were the secondary outcomes.Results CO after the intervention was higher in the atropine (group I) than in the control (group II). Also, CO reduction at 5 and 10 min following spinal anesthesia was less in the group I than in the group II. Except for baseline reading, HR was significantly higher in the atropine group versus the control group. MBP was higher in the atropine group than in the control group in all readings. SV and SVR were similar in both groups. Neonatal outcomes were equivalent in both groups.Conclusion Pre-spinal atropine was effective in preventing post-spinal bradycardia and minimized CO reduction in patients undergoing elective cesarean delivery under spinal anesthesia.
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spelling doaj.art-3933337cffca42149d36ce798241ec362023-07-17T16:12:27ZengTaylor & Francis GroupEgyptian Journal of Anaesthesia1110-18492023-12-0139157157810.1080/11101849.2023.2236866Impact of pre-spinal atropine on post spinal hemodynamic and cardiac output measured by electrical cardiometry in cesarean delivery, a randomized controlled trialAmin M. Alansary0Mohamed Mourad Ali1Minatallah Ali Elshafie2Department of Anesthesiology, Intensive Care and Pain Management, Faculty of Medicine, Ain Shams University, Cairo, EgyptDepartment of Anesthesiology, Intensive Care and Pain Management, Faculty of Medicine, Ain Shams University, Cairo, EgyptDepartment of Anesthesia, National Liver Institute, Menoufia University, Sheeben Elkom, EgyptABSTRACTBackground Spinal anesthesia is a widely used technique for cesarean delivery, but it often results in hypotension, bradycardia, and reduced cardiac output (CO). Atropine has a potent muscarinic receptor antagonist activity in the heart. It may be a good choice to prevent post-spinal bradycardia and minimize the marked CO reduction.Methods Sixty pregnant women between the ages of 18 and 40 who were ASA-PS II and planned for elective cesarean delivery were divided into two equal groups at random. Both groups received spinal anesthesia. Atropine group (I) (n = 30): patients received 0.01 mg/kg atropine, while control group (II) (n = 30): patients received the same volume of saline. CO measured by electrical cardiometry (EC) was the primary outcome where, heart rate (HR), mean blood pressure (MBP), stroke volume (SV), systemic vascular resistance (SVR), and neonatal outcomes were the secondary outcomes.Results CO after the intervention was higher in the atropine (group I) than in the control (group II). Also, CO reduction at 5 and 10 min following spinal anesthesia was less in the group I than in the group II. Except for baseline reading, HR was significantly higher in the atropine group versus the control group. MBP was higher in the atropine group than in the control group in all readings. SV and SVR were similar in both groups. Neonatal outcomes were equivalent in both groups.Conclusion Pre-spinal atropine was effective in preventing post-spinal bradycardia and minimized CO reduction in patients undergoing elective cesarean delivery under spinal anesthesia.https://www.tandfonline.com/doi/10.1080/11101849.2023.2236866Atropinecardiac outputcaesarean deliveryelectrical cardiometryspinal anesthesia
spellingShingle Amin M. Alansary
Mohamed Mourad Ali
Minatallah Ali Elshafie
Impact of pre-spinal atropine on post spinal hemodynamic and cardiac output measured by electrical cardiometry in cesarean delivery, a randomized controlled trial
Egyptian Journal of Anaesthesia
Atropine
cardiac output
caesarean delivery
electrical cardiometry
spinal anesthesia
title Impact of pre-spinal atropine on post spinal hemodynamic and cardiac output measured by electrical cardiometry in cesarean delivery, a randomized controlled trial
title_full Impact of pre-spinal atropine on post spinal hemodynamic and cardiac output measured by electrical cardiometry in cesarean delivery, a randomized controlled trial
title_fullStr Impact of pre-spinal atropine on post spinal hemodynamic and cardiac output measured by electrical cardiometry in cesarean delivery, a randomized controlled trial
title_full_unstemmed Impact of pre-spinal atropine on post spinal hemodynamic and cardiac output measured by electrical cardiometry in cesarean delivery, a randomized controlled trial
title_short Impact of pre-spinal atropine on post spinal hemodynamic and cardiac output measured by electrical cardiometry in cesarean delivery, a randomized controlled trial
title_sort impact of pre spinal atropine on post spinal hemodynamic and cardiac output measured by electrical cardiometry in cesarean delivery a randomized controlled trial
topic Atropine
cardiac output
caesarean delivery
electrical cardiometry
spinal anesthesia
url https://www.tandfonline.com/doi/10.1080/11101849.2023.2236866
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