Special maternal care bundle to attenuate post-spinal hypotension in cesarean section: A randomized controlled clinical trial
ABSTRACTBackground This study aimed to assess the safety and efficacy of a special maternal care bundle as an alternative technique for the attenuation of hypotension following spinal anesthesia in parturients scheduled for CS.Methods This double-blinded, parallel-group, randomized trial enrolled 13...
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| Format: | Article |
| Language: | English |
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Taylor & Francis Group
2023-12-01
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| Series: | Egyptian Journal of Anaesthesia |
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| Online Access: | https://www.tandfonline.com/doi/10.1080/11101849.2023.2194094 |
| _version_ | 1797861888582746112 |
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| author | Abdelrhman Alshawadfy Shaimaa A. Dahshan Ahmed A. Ellilly Ahmed M. Elewa |
| author_facet | Abdelrhman Alshawadfy Shaimaa A. Dahshan Ahmed A. Ellilly Ahmed M. Elewa |
| author_sort | Abdelrhman Alshawadfy |
| collection | DOAJ |
| description | ABSTRACTBackground This study aimed to assess the safety and efficacy of a special maternal care bundle as an alternative technique for the attenuation of hypotension following spinal anesthesia in parturients scheduled for CS.Methods This double-blinded, parallel-group, randomized trial enrolled 138 adult parturients who were scheduled for CS under spinal anesthesia. The patients were randomly allocated to two groups. In the care bundle group, 68 participants received a co-load of lactated Ringer’s solution and ondansetron infusion during administration of spinal anesthesia with a slow rate intrathecal bupivacaine injection and a V-shaped supine position. While in the best practice group, 70 participants received a co-loaded lactated Ringer’s solution during spinal anesthesia with early use of vasopressors and a left uterine tilting position. The primary outcome was the total ephedrine consumption. Secondary outcomes included the mean arterial blood pressure, heart rate, atropine usage, complications such as dizziness, nausea, and vomiting, as well as the baby’s Apgar score.Results Special maternal care bundle significantly reduced the need and the total dose of ephedrine (P = 0.042). The mean arterial blood pressure was significantly less affected by maternal bundle care, but the reduction in heart rate, the need for atropine, the incidence of dizziness, nausea, vomiting, and the Apgar score were comparable in both groups.Conclusion The special maternal care bundle including co-load of lactated ringer, ondansetron 4 mg IV infusion, slow intrathecal injection and v-shaped positions can reduce the incidence of hypotension resulting from spinal anesthesia and ephedrine usage during CS. |
| first_indexed | 2024-04-09T22:10:31Z |
| format | Article |
| id | doaj.art-4ccac0fdba9f42f681c740172826fe74 |
| institution | Directory Open Access Journal |
| issn | 1110-1849 |
| language | English |
| last_indexed | 2024-04-09T22:10:31Z |
| publishDate | 2023-12-01 |
| publisher | Taylor & Francis Group |
| record_format | Article |
| series | Egyptian Journal of Anaesthesia |
| spelling | doaj.art-4ccac0fdba9f42f681c740172826fe742023-03-23T12:02:18ZengTaylor & Francis GroupEgyptian Journal of Anaesthesia1110-18492023-12-0139129630310.1080/11101849.2023.2194094Special maternal care bundle to attenuate post-spinal hypotension in cesarean section: A randomized controlled clinical trialAbdelrhman Alshawadfy0Shaimaa A. Dahshan1Ahmed A. Ellilly2Ahmed M. Elewa3Department of Anesthesia and Intensive Care, Faculty of Medicine, Suez Canal University, Ismailia, EgyptDepartment of Anesthesia and Intensive Care, Faculty of Medicine, Suez Canal University, Ismailia, EgyptDepartment of Anesthesia and Intensive Care, Faculty of Medicine, Suez Canal University, Ismailia, EgyptDepartment of Anesthesia and Intensive Care, Faculty of Medicine, Suez Canal University, Ismailia, EgyptABSTRACTBackground This study aimed to assess the safety and efficacy of a special maternal care bundle as an alternative technique for the attenuation of hypotension following spinal anesthesia in parturients scheduled for CS.Methods This double-blinded, parallel-group, randomized trial enrolled 138 adult parturients who were scheduled for CS under spinal anesthesia. The patients were randomly allocated to two groups. In the care bundle group, 68 participants received a co-load of lactated Ringer’s solution and ondansetron infusion during administration of spinal anesthesia with a slow rate intrathecal bupivacaine injection and a V-shaped supine position. While in the best practice group, 70 participants received a co-loaded lactated Ringer’s solution during spinal anesthesia with early use of vasopressors and a left uterine tilting position. The primary outcome was the total ephedrine consumption. Secondary outcomes included the mean arterial blood pressure, heart rate, atropine usage, complications such as dizziness, nausea, and vomiting, as well as the baby’s Apgar score.Results Special maternal care bundle significantly reduced the need and the total dose of ephedrine (P = 0.042). The mean arterial blood pressure was significantly less affected by maternal bundle care, but the reduction in heart rate, the need for atropine, the incidence of dizziness, nausea, vomiting, and the Apgar score were comparable in both groups.Conclusion The special maternal care bundle including co-load of lactated ringer, ondansetron 4 mg IV infusion, slow intrathecal injection and v-shaped positions can reduce the incidence of hypotension resulting from spinal anesthesia and ephedrine usage during CS.https://www.tandfonline.com/doi/10.1080/11101849.2023.2194094Care bundleephedrinehypotensionmultimodalspinal anesthesia |
| spellingShingle | Abdelrhman Alshawadfy Shaimaa A. Dahshan Ahmed A. Ellilly Ahmed M. Elewa Special maternal care bundle to attenuate post-spinal hypotension in cesarean section: A randomized controlled clinical trial Egyptian Journal of Anaesthesia Care bundle ephedrine hypotension multimodal spinal anesthesia |
| title | Special maternal care bundle to attenuate post-spinal hypotension in cesarean section: A randomized controlled clinical trial |
| title_full | Special maternal care bundle to attenuate post-spinal hypotension in cesarean section: A randomized controlled clinical trial |
| title_fullStr | Special maternal care bundle to attenuate post-spinal hypotension in cesarean section: A randomized controlled clinical trial |
| title_full_unstemmed | Special maternal care bundle to attenuate post-spinal hypotension in cesarean section: A randomized controlled clinical trial |
| title_short | Special maternal care bundle to attenuate post-spinal hypotension in cesarean section: A randomized controlled clinical trial |
| title_sort | special maternal care bundle to attenuate post spinal hypotension in cesarean section a randomized controlled clinical trial |
| topic | Care bundle ephedrine hypotension multimodal spinal anesthesia |
| url | https://www.tandfonline.com/doi/10.1080/11101849.2023.2194094 |
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