The Effect of Intraoperative Hypotension on Postoperative Cognitive Functions in Cesarean Section Operations

NCT ID: NCT05843838

Last Updated: 2024-02-08

Study Results

Results pending

The study team has not published outcome measurements, participant flow, or safety data for this trial yet. Check back later for updates.

Basic Information

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Recruitment Status

RECRUITING

Clinical Phase

NA

Total Enrollment

150 participants

Study Classification

INTERVENTIONAL

Study Start Date

2024-02-01

Study Completion Date

2024-05-01

Brief Summary

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The aim of the study is to see whether the hypotension that develops during spinal anesthesia in cesarean section patients causes a decrease in the postoperative cognitive functions of the patient. If the results show a decrease in functions due to the effect of hypotension, it will be necessary to carry out aggressive prevention/treatment of hypotension in cesarean section patients.

Detailed Description

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A total of 150 female patients (75 in each group) between the ages of 18-40 who will undergo caesarean section with spinal anesthesia in the obstetric operating room of Ankara Bilkent City Hospital in ASA 2, 3rd categories will be included in the study.

Patients will be divided into two as hypotensive and non-hypotensive patients in spinal anesthesia with routine doses, and all patients will be given a mini mental test at preop and post op 1st hour. (Hypotension, MAP(mean artery pressure)\<65 mmHg, or SAP(systemic arterial pressure) \< 30% will be considered as an initial value.) Patients who are hypotensive and need ephedrine will be included in the hypotensive group, and patients without hypotension will be included in the normotensive group. Those with an initial mini mental test score below 24 will not be allowed to study. At the end of the research, the mental test scores of the two groups will be compared and the effect of hypotension will be evaluated.

The patient's name-surname, age, protocol number, indication for cesarean section, method of regional anesthesia applied, sensory block level, Bromage score, side effect follow-up, first ten minutes after the procedure, every two minutes, up to half an hour, and every fifteen minutes after thirty minutes, systolic artery pressure, diastolic artery pressure, average arterial pressure, pulse and ephedrine (if used) will be recorded.

Preoperative, Postoperative first hour Mini Mental Test Score will be administered and recorded

Conditions

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Postoperative Cognitive Dysfunction

Study Design

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Allocation Method

RANDOMIZED

Intervention Model

PARALLEL

Primary Study Purpose

DIAGNOSTIC

Blinding Strategy

SINGLE

Participants

Study Groups

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Hypotensive group

Patients who are hypotensive (even once) and need ephedrine under spinal anesthesia with routine doses of heavy bupivacaine (Hypotension, Mean Arterial Pressure\<65 mmHg, or Systolic arterial pressure \< 30% will be considered an initial value.)

Group Type EXPERIMENTAL

Hypotension during spinal anesthesia for cesarean section

Intervention Type PROCEDURE

Hypotension, Mean Arterial Pressure\<65 mmHg, or Systolic arterial pressure \< 30% will be considered an initial value

Mini-mental test

Intervention Type DIAGNOSTIC_TEST

A Mini-Mental State test is a set of questions that doctors and other healthcare professionals commonly use to check for cognitive impairment (problems with thinking, communication, understanding and memory).

At the end of the research, the mental test scores of the two groups will be compared and the effect of hypotension will be evaluated.

Spinal anesthesia

Intervention Type PROCEDURE

It is a neuraxial anesthesia technique in which local anesthetic is placed directly in the intrathecal space. Spinal anesthesia will be applied to both groups with heavy bupivacaine in usual doses.

The Bromage scale

Intervention Type DIAGNOSTIC_TEST

The Bromage scale is the accepted tool for motor block examination. The classification of these scores

1. complete block: unable to move feet or knees
2. almost complete: able to move feet only
3. partial: just able to flex knees; free movement of feet
4. no block: full movement of knees and feet

Heavy Bupivacaine for spinal anesthesia

Intervention Type DRUG

Routine clinical heavy bupivacaine doses

Normotensive group

Patients who are not hypotensive under spinal anesthesia with routine doses of heavy bupivacaine

Group Type PLACEBO_COMPARATOR

Mini-mental test

Intervention Type DIAGNOSTIC_TEST

A Mini-Mental State test is a set of questions that doctors and other healthcare professionals commonly use to check for cognitive impairment (problems with thinking, communication, understanding and memory).

At the end of the research, the mental test scores of the two groups will be compared and the effect of hypotension will be evaluated.

Spinal anesthesia

Intervention Type PROCEDURE

It is a neuraxial anesthesia technique in which local anesthetic is placed directly in the intrathecal space. Spinal anesthesia will be applied to both groups with heavy bupivacaine in usual doses.

The Bromage scale

Intervention Type DIAGNOSTIC_TEST

The Bromage scale is the accepted tool for motor block examination. The classification of these scores

1. complete block: unable to move feet or knees
2. almost complete: able to move feet only
3. partial: just able to flex knees; free movement of feet
4. no block: full movement of knees and feet

Heavy Bupivacaine for spinal anesthesia

Intervention Type DRUG

Routine clinical heavy bupivacaine doses

Interventions

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Hypotension during spinal anesthesia for cesarean section

Hypotension, Mean Arterial Pressure\<65 mmHg, or Systolic arterial pressure \< 30% will be considered an initial value

Intervention Type PROCEDURE

Mini-mental test

A Mini-Mental State test is a set of questions that doctors and other healthcare professionals commonly use to check for cognitive impairment (problems with thinking, communication, understanding and memory).

At the end of the research, the mental test scores of the two groups will be compared and the effect of hypotension will be evaluated.

Intervention Type DIAGNOSTIC_TEST

Spinal anesthesia

It is a neuraxial anesthesia technique in which local anesthetic is placed directly in the intrathecal space. Spinal anesthesia will be applied to both groups with heavy bupivacaine in usual doses.

Intervention Type PROCEDURE

The Bromage scale

The Bromage scale is the accepted tool for motor block examination. The classification of these scores

1. complete block: unable to move feet or knees
2. almost complete: able to move feet only
3. partial: just able to flex knees; free movement of feet
4. no block: full movement of knees and feet

Intervention Type DIAGNOSTIC_TEST

Heavy Bupivacaine for spinal anesthesia

Routine clinical heavy bupivacaine doses

Intervention Type DRUG

Eligibility Criteria

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Inclusion Criteria

* Female patients between the ages of 18-40 in the ASA2, 3rd categories who will undergo cesarean section with spinal anesthesia who agree to participate in the study

Exclusion Criteria

* Failure of the patient to accept
* The necessity of an additional intervention to the cesarean section
* Change of routine practices on a patient-by-patient basis with the occurrence of complications in the surgical process
* Presence of additional diseases
* Emergency cases, cases using intraoperative sedation
* Those who do not speak the language
* Those who have an initial Mini Mental Test score lower than 24
Minimum Eligible Age

18 Years

Maximum Eligible Age

40 Years

Eligible Sex

FEMALE

Accepts Healthy Volunteers

Yes

Sponsors

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Ankara City Hospital Bilkent

OTHER

Sponsor Role lead

Responsible Party

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Responsibility Role SPONSOR

Principal Investigators

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esra uyar türkyılmaz

Role: PRINCIPAL_INVESTIGATOR

Ankara Bilkent City Hospital Ankara Turkey

Locations

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Ankara Bilkent City Hospital

Ankara, , Turkey (Türkiye)

Site Status RECRUITING

Countries

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Turkey (Türkiye)

Central Contacts

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nihan aydın güzey

Role: CONTACT

+90 505 6496231

Facility Contacts

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nihan aydın güzey

Role: primary

05056496231

Other Identifiers

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E2-23-3719

Identifier Type: -

Identifier Source: org_study_id

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