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Trial registered on ANZCTR
Registration number
ACTRN12611000608965
Ethics application status
Approved
Date submitted
9/06/2011
Date registered
14/06/2011
Date last updated
15/06/2011
Type of registration
Retrospectively registered
Titles & IDs
Public title
Keeping parturient in the left lateral position after spinal anesthesia with plain levobupivacaine at cesarean section reduces hypotension
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Scientific title
Keeping the parturients in the left lateral position for few minutes obtains dense anesthesia for the surgical site (below T10), and delayed placing to the supine position provides less dense anesthesia up to T5 to relieve the visceral part of surgical pain
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Secondary ID [1]
262351
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Nil
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Universal Trial Number (UTN)
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Trial acronym
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Linked study record
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Health condition
Health condition(s) or problem(s) studied:
Cesarean section
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spinal anesthesia
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Hypotension
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Condition category
Condition code
Reproductive Health and Childbirth
268195
268195
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0
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Normal pregnancy
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Anaesthesiology
268224
268224
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0
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Anaesthetics
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Intervention/exposure
Study type
Interventional
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Description of intervention(s) / exposure
Intrathecal injection was performed in the left lateral decubitus position at the L3-4 or L2-3 interspace with a 25-gauge Quincke needle. Following free flow of cerebrospinal fluid, 2.5 mL of 0.5% isobaric levobupivacaine (Chirocaine amp, Abbott, Norway) was administered over 20 seconds without barbotage. After withdrawing the spinal needle, the patients in Group L were kept in the left lateral decubitus position for 15 minutes, after which they were turned to the supine position.
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Intervention code [1]
266740
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Treatment: Drugs
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Intervention code [2]
266741
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Prevention
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Intervention code [3]
266742
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Treatment: Other
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Comparator / control treatment
After withdrawing the spinal needle, the patients in Group S patients were immediately placed in the supine position.
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Control group
Active
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Outcomes
Primary outcome [1]
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hypotension with using clinical assessments
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Assessment method [1]
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Timepoint [1]
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during operation
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Secondary outcome [1]
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Nausea with using clinical assessments
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Assessment method [1]
276650
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Timepoint [1]
276650
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during operation
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Secondary outcome [2]
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vomiting with using clinical assessments
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Assessment method [2]
276651
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Timepoint [2]
276651
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during operation
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Secondary outcome [3]
276652
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satisfaction with using clinical assessments
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Assessment method [3]
276652
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Timepoint [3]
276652
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during operation
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Eligibility
Key inclusion criteria
Healthy, full-term parturients scheduled for elective cesarean section
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Minimum age
18
Years
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Maximum age
40
Years
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Sex
Females
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Can healthy volunteers participate?
Yes
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Key exclusion criteria
Hypertension, preeclampsia, hypersensitivity to relevant drugs.
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Study design
Purpose of the study
Prevention
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Allocation to intervention
Randomised controlled trial
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Procedure for enrolling a subject and allocating the treatment (allocation concealment procedures)
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Methods used to generate the sequence in which subjects will be randomised (sequence generation)
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Masking / blinding
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Who is / are masked / blinded?
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Intervention assignment
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Other design features
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Phase
Phase 4
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Type of endpoint/s
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Statistical methods / analysis
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Recruitment
Recruitment status
Completed
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Date of first participant enrolment
Anticipated
15/11/2010
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Actual
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Date of last participant enrolment
Anticipated
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Actual
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Date of last data collection
Anticipated
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Actual
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Sample size
Target
60
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Accrual to date
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Final
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Recruitment outside Australia
Country [1]
3623
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Turkey
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State/province [1]
3623
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Funding & Sponsors
Funding source category [1]
267229
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Hospital
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Name [1]
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Hospital of Gaziantep University
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Address [1]
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University st. 27310 Sehitkamil Gaziantep
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Country [1]
267229
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Turkey
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Primary sponsor type
Individual
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Name
Levent Sahin
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Address
University st. 27310 Sehitkamil Gaziantep
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Country
Turkey
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Secondary sponsor category [1]
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None
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Name [1]
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Address [1]
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Country [1]
266293
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Ethics approval
Ethics application status
Approved
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Ethics committee name [1]
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Ethical Committee of Gaziantep University Hospitals
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Ethics committee address [1]
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Gaziantep University, University st. 27310, Sehitkamil, GAziantep
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Ethics committee country [1]
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Turkey
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Date submitted for ethics approval [1]
269220
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Approval date [1]
269220
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Ethics approval number [1]
269220
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Summary
Brief summary
Hypotension during spinal anesthesia is one of the main concerns in cesarean delivery. We hypothesized that keeping the parturients in the left lateral position for few minutes obtains dense anesthesia for the surgical site (below T10), and delayed placing to the supine position provides less dense anesthesia up to T5 to relieve the visceral part of surgical pain. Less dense anesthesia in the upper thoracic segments results in incomplete sympathetic block and low incidence of hypotension. Method: In this prospective study, 60 parturients undergoing cesarean section were randomized for turning to supine position just after subarachnoid injection of 2.5 mL 0.5% plain levobupivacaine in lateral position or to stay in lateral position for 15 minutes before supine positioning. Loss of pinprick sensation to T6 was accepted as adequate for cesarean section, and surgery proceeded. Characteristics of anesthesia, incidences of hypotension, bradycardia, other adverse events, and ephedrine use were assessed. Results: Compared to the supine group, the parturients kept in lateral position for 15 minutes experienced a marked decrease in the incidence of hypotension (33.3% vs. 83.3%, P<0.001) and adverse events related to hypotension such as nausea and vomiting (16.7% vs. 57.3%, P<0.001). In addition, ephedrine consumption per hypotension case was significantly reduced in the lateral group (5.4 +/- 4.7 mg vs 8.9 +/- 5.8, p<0.001). Conclusion: Keeping parturients in the lateral position for 15 minutes before turning to the supine position in cesarean section can provide a reliable spinal anesthesia with lower incidence and severity of hypotension and nausea/vomiting.
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Trial website
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Trial related presentations / publications
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Public notes
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Contacts
Principal investigator
Name
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Address
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Country
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Phone
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Fax
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Email
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Contact person for public queries
Name
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Levent Sahin
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Address
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Gaziantep University, University st. 27310, SEhitkamil Gaziantep
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Country
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Turkey
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Phone
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00 90 342 3606060 # 77804
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Fax
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Email
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[email protected]
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Contact person for scientific queries
Name
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Levent Sahin
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Address
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Gaziantep University, University st. 27310, SEhitkamil Gaziantep
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Country
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Turkey
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Phone
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00 90 342 3606060 # 77804
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Fax
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Email
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[email protected]
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No information has been provided regarding IPD availability
What supporting documents are/will be available?
No Supporting Document Provided
Results publications and other study-related documents
Documents added manually
No documents have been uploaded by study researchers.
Documents added automatically
No additional documents have been identified.
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