ArticleJournal of anesthesia, analgesia and critical care2026
Caffeine before cesarean delivery: a novel preventive strategy against spinal hypotension, a double blind placebo-controlled trial.
Article in Journal of anesthesia, analgesia and critical care, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. It is linked to 2 registered trials, which are not on this map. Cited by 3 papers.
What it found
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The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
The trial behind it
Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
Effectiveness of Preoperative Oral Caffeine in Preventing Spinal-Induced Hypotension During Cesarean Delivery: A Double Blind Randomized Controlled Trial
Effect of Preoperative Oral Caffeine on Prophylactic Noradrenaline Requirement During Cesarean Delivery: A Double-blind Placebo-controlled Trial
Who cites it
3 citing papers in PubMed.
- Reply to commentary on "The influence of thirty-degree leg elevation on noradrenaline requirements administered as a prophylactic variable infusion during cesarean delivery, an open-label randomized controlled trial."Journal of anesthesia, analgesia and critical care · 2026Article
- Post-spinal cesarean hypotension.Journal of anesthesia, analgesia and critical care · 2026Article
- Prediction of spinal anesthesia-induced hypotension during cesarean delivery: a narrative review.Journal of anesthesia, analgesia and critical care · 2026Review
Corrections and comments
PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.
Authors and funding
8 authors.
Funding
No grant is acknowledged in the PubMed record.
Abstract
backgroundSpinal anesthesia-induced hypotension is a common complication during cesarean delivery, often requiring vasopressor support, and is associated with maternal discomfort. Caffeine, a central nervous system stimulant with well-documented cardiovascular effects, may provide a simple adjunct to enhance hemodynamic stability. We aimed to evaluate the efficacy of a single preoperative 200 mg oral caffeine dose in reducing the incidence and severity of hypotension following spinal anesthesia in healthy patients undergoing elective cesarean delivery.
methodsIn this randomized controlled trial, 90 patients classified as ASA II and scheduled for elective cesarean delivery under spinal anesthesia were assigned to receive either 200 mg oral caffeine or a placebo 30 min before the procedure. Hemodynamic parameters, the incidence and severity of hypotension, baseline and 60 min post-administration serum caffeine levels, ephedrine requirements, incidence of postoperative nausea and vomiting, and post-dural puncture headache were recorded and analyzed.
resultsCaffeine administration significantly reduced the incidence of hypotension (9% vs. 33%, p < 0.05). Severe hypotension was not observed in the caffeine group. Patients in the caffeine group demonstrated greater hemodynamic stability, with a delayed onset of hypotension and reduced ephedrine requirements. No significant differences were observed in the incidence of bradycardia, tachycardia, or reactive hypertension. Neonatal outcomes were comparable between the groups. Additionally, caffeine was associated with lower rates of postoperative nausea and vomiting (2% vs. 20%) and post-dural puncture headache (2% vs. 16%) at 24 h.
conclusionPreoperative administration of 200 mg oral caffeine is a cost-effective strategy for reducing spinal anesthesia-induced hypotension, the incidence of postoperative nausea and vomiting, and post-dural puncture headache in healthy patients undergoing elective cesarean delivery. These findings support further investigation of the role of caffeine as an adjunct in obstetric anesthesia.
trial registrationThe study was registered by the principal investigator (M. Helmy) at ClinicalTrials.gov under the identifier NCT07076654 on July 11, 2025.
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Registered trials
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