Norepinephrine Versus Ephedrin for Prevention of Post Spinal Anesthesia in Cesarean Section
Primary Purpose
Maternal Hypotension Syndrome, Cesarean
Status
Unknown status
Phase
Phase 4
Locations
Study Type
Interventional
Intervention
Ephedrine
Norepinephrine
Sponsored by
About this trial
This is an interventional prevention trial for Maternal Hypotension Syndrome
Eligibility Criteria
Inclusion Criteria:
- full termed parturients scheduled for elective or semi urgent cesarean section under spinal anesthesia
- AGE>15 years
- ASA II status
- No history of hypertension, preeclampsia or cardiopathy
- BMI<40
Exclusion Criteria:
- cesarean section under genearl anesthesia or epidural analgesia during labor
Sites / Locations
Arms of the Study
Arm 1
Arm 2
Arm Type
Experimental
Experimental
Arm Label
norepinephrin group
Ephedrin group
Arm Description
The patients of this group will recieve 0.5 micro gr/kg of norepinephin intravenously, the infusion will start during the intrathecal injection and during 10 minutes
The patients of this group will recieve 0,3mg/kg of Ephedrin intravenously, the infusion will start during the intrathecal injection and during 10 minutes
Outcomes
Primary Outcome Measures
Incidence of post spinal hypotension
decrease of systolic arterial blood pressure > 20% baseline
Secondary Outcome Measures
Lowest systolic blood pressure
Lowest systolic blood pressure recorded after spinal anesthesia
Incidence of bradycardia
heart rate<50 beats/min
incidence of nausea and/or vomiting
incidence of nausea and/or vomiting
Apgar score
Apgar score at 1 min, 5 min, 10 min
fetal ph
fetal ph
fetal blood lactates
fetal blood lactates
Full Information
NCT ID
NCT03719625
First Posted
October 19, 2018
Last Updated
November 30, 2018
Sponsor
Mongi Slim Hospital
1. Study Identification
Unique Protocol Identification Number
NCT03719625
Brief Title
Norepinephrine Versus Ephedrin for Prevention of Post Spinal Anesthesia in Cesarean Section
Official Title
Norepinephrine Versus Ephedrin for Prevention of Post Spinal Anesthesia in Cesarean Section
Study Type
Interventional
2. Study Status
Record Verification Date
October 2018
Overall Recruitment Status
Unknown status
Study Start Date
January 2, 2019 (Anticipated)
Primary Completion Date
May 30, 2019 (Anticipated)
Study Completion Date
May 30, 2019 (Anticipated)
3. Sponsor/Collaborators
Responsible Party, by Official Title
Principal Investigator
Name of the Sponsor
Mongi Slim Hospital
4. Oversight
Studies a U.S. FDA-regulated Drug Product
No
Studies a U.S. FDA-regulated Device Product
No
Product Manufactured in and Exported from the U.S.
No
Data Monitoring Committee
No
5. Study Description
Brief Summary
Spinal anesthesia is still the gold standard anesthetic method for elective and urgent cesarean section, the post spinal hypotension remains the most frequent complication of this procedure and is still responsible of considerable maternel and fetal morbidity. It is recommanded to prevent this post spinal hypotension with fluid coloading and prophylactic vasopressors administration.
The aim of this study is to compare the efficency and the safety of norepinephrin and ephedrin prophylactic administration to reduce the incidence of post spinal hypotension in cesarean section.
Detailed Description
Spinal anesthesia is still the gold standard anesthetic method for elective and urgent cesarean section, the post spinal hypotension remains the most frequent complication of this procedure and is still responsible of considerable maternel and fetal morbidity. It is recommanded to prevent this post spinal hypotension with fluid coloading and prophylactic vasopressors administration. The prophylactic use of norepinephrin and phenylephrin has been validated by several studies, but few data are published concerning the comparaison between norepinephrin and ephedrine as preventive vasopressors in cesarean section; these molecules act on alpha and beta adrenergic receptors and could provide better maternal hemodynamics in parturients undergoing cesarean section under spinal anesthesia.
The aim of this study is to compare the efficency and the safety of norepinephrin and ephedrin prophylactic administration to reduce the incidence of post spinal hypotension in cesarean section.
6. Conditions and Keywords
Primary Disease or Condition Being Studied in the Trial, or the Focus of the Study
Maternal Hypotension Syndrome, Cesarean
7. Study Design
Primary Purpose
Prevention
Study Phase
Phase 4
Interventional Study Model
Parallel Assignment
Model Description
controlled, prospective, randomised trial comparing 2 interventions
Masking
Participant
Allocation
Randomized
Enrollment
200 (Anticipated)
8. Arms, Groups, and Interventions
Arm Title
norepinephrin group
Arm Type
Experimental
Arm Description
The patients of this group will recieve 0.5 micro gr/kg of norepinephin intravenously, the infusion will start during the intrathecal injection and during 10 minutes
Arm Title
Ephedrin group
Arm Type
Experimental
Arm Description
The patients of this group will recieve 0,3mg/kg of Ephedrin intravenously, the infusion will start during the intrathecal injection and during 10 minutes
Intervention Type
Drug
Intervention Name(s)
Ephedrine
Other Intervention Name(s)
Ephedrin
Intervention Description
Comparaison of Norepinephrin and Ephedrin for prevention of the post spinal anesthesia in cesarean section
Intervention Type
Drug
Intervention Name(s)
Norepinephrine
Intervention Description
Comparaison of Norepinephrin and Ephedrin for prevention of the post spinal anesthesia in cesarean section
Primary Outcome Measure Information:
Title
Incidence of post spinal hypotension
Description
decrease of systolic arterial blood pressure > 20% baseline
Time Frame
during the first 20 minutes after spinal anesthesia
Secondary Outcome Measure Information:
Title
Lowest systolic blood pressure
Description
Lowest systolic blood pressure recorded after spinal anesthesia
Time Frame
uring the first 20 minutes after spinal anesthesia
Title
Incidence of bradycardia
Description
heart rate<50 beats/min
Time Frame
during the first 20 minutes after spinal anesthesia
Title
incidence of nausea and/or vomiting
Description
incidence of nausea and/or vomiting
Time Frame
during the first 20 minutes after spinal anesthesia
Title
Apgar score
Description
Apgar score at 1 min, 5 min, 10 min
Time Frame
20min after spinal anesthesia
Title
fetal ph
Description
fetal ph
Time Frame
20min after spinal anesthesia
Title
fetal blood lactates
Description
fetal blood lactates
Time Frame
20min after spinal anesthesia
10. Eligibility
Sex
Female
Gender Based
Yes
Gender Eligibility Description
this study is exclusively including paturients undergoing cesarean section
Minimum Age & Unit of Time
15 Years
Maximum Age & Unit of Time
45 Years
Accepts Healthy Volunteers
Accepts Healthy Volunteers
Eligibility Criteria
Inclusion Criteria:
full termed parturients scheduled for elective or semi urgent cesarean section under spinal anesthesia
AGE>15 years
ASA II status
No history of hypertension, preeclampsia or cardiopathy
BMI<40
Exclusion Criteria:
cesarean section under genearl anesthesia or epidural analgesia during labor
Central Contact Person:
First Name & Middle Initial & Last Name or Official Title & Degree
Asma Ben Souissi, assistant professor
Phone
0021698336883
Email
bsouissiasma@gmail.com
First Name & Middle Initial & Last Name or Official Title & Degree
Mhamed Sami Mebazaa, Professor
Phone
0021622252589
Email
msmebazaa@gmail.com
12. IPD Sharing Statement
Plan to Share IPD
Undecided
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Norepinephrine Versus Ephedrin for Prevention of Post Spinal Anesthesia in Cesarean Section
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