Effect of Goal-Directed Fluid Therapy on Hypotension From Spinal Anesthesia in Older Parturients Having Cesarean Section: A Randomized Controlled Trial.

Background: The proportion of advanced maternal age (AMA) parturients in China has gradually increased. AMA is considered a risk factor for adverse maternal and fetal outcomes. Goal-directed fluid therapy (GDFT) was used to guide perioperative volume management in order to reduce spinal anesthesia-induced hypotension and optimize maternal and infant outcomes for AMA parturients undergoing cesarean section. The primary endpoint of this study was the incidence of hypotension induced by spinal anesthesia in AMA parturients undergoing cesarean section. Secondary outcomes included intraoperative infusion volume, time to first postoperative flatus, postoperative blood loss within 24 h, neonatal 1-min and 5-min Apgar scores, umbilical artery blood gas analysis, and NICU transfer rate. Methods: A total of 69 AMA parturients with BMI ≤ 35 kg/m Result: Compared with Group C, the amount of predelivery fluid and intraoperative infusion in Group G was significantly reduced ( Conclusion: SV-oriented GDFT based on TTE can reduce the incidence of hypotension after subarachnoid block during cesarean section in AMA parturients. Although there is no significant difference in maternal and infant outcome, the first postoperative flatus time was shortened with a certain degree of clinical significance. Trial Registration: Chinese Registry of Clinical Trials: ChiCTR2300068420.