ArticleEuropean journal of anaesthesiology and intensive care2025
Prevention of spinal anaesthesia-induced hypotension during caesarean section using noninvasive cardiac output monitoring: A randomised clinical trial.
Article in European journal of anaesthesiology and intensive care, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 1 paper.
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Who cites it
1 citing paper in PubMed.
- Serial transthoracic echocardiography for hemodynamic monitoring and early warning of hypotension during elective cesarean delivery: a prospective observational study.Journal of clinical monitoring and computing · 2026Article
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8 authors.
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Abstract
backgroundHypotension following spinal anaesthesia during caesarean section is common and can negatively affect the mother and child.
objectiveThis study aimed to assess whether spinal anaesthesia-induced hypotension could be prevented using noninvasive cardiac output monitoring.
designRandomised controlled study.
settingThis single-centre study was conducted at a Japanese hospital from 13 May 2020 to 27 April 2022. PATIENTS: Women (
interventionThe participants were randomised via simple randomisation into the estimated continuous cardiac output-guided vasopressor administration (esCCO group) or control group. Blood pressure was measured at 2.5-min intervals following intrathecal 10 mg hyperbaric bupivacaine injection. Patients in both groups received a single dose of vasopressor (phenylephrine 100 μg or ephedrine 4 mg) if they had hypotension (systolic BP <100 mmHg and/or mean BP <65 mmHg) or nausea. In the esCCO group, phenylephrine was also administered if the esCCO decreased by 10% or more from baseline.
main outcome measuresThe primary outcome was the proportion of patients with hypotension (systolic blood pressure < 100 mmHg and/or mean blood pressure < 65 mmHg) between the spinal anaesthesia injection and delivery. The secondary outcomes were nausea and vomiting, reactive hypertension (systolic BP ≥ 140 mmHg), and umbilical arterial blood pH. Fisher's exact test and Student's
resultsThe incidence of hypotension was 43/88 (49%) in the control group and 20/103 (19%) in the esCCO group (
conclusionThe incidence of hypotension may be reduced using estimated continuous CO monitoring, however, no differences were seen in the incidence of nausea or reactive hypertension, nor in umbilical arterial pH levels.
trial registrationUMIN-CTR Clinical Trial Database identifier: UMIN000040066.
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