About this trial
Spinal anesthesia is the preferred regional technique in obstetric practice because it provides high maternal satisfaction and eliminates the need for airway manipulation. Despite these advantages, it is frequently complicated by spinal anesthesia-induced hypotension , defined as a reduction in systolic blood pressure of more than 20% from baseline or an absolute SBP below 100 mmHg. Spinal hypotension can have serious consequences, including maternal hypoperfusion that may lead to neurological or renal dysfunction, as well as fetal acidosis and bradycardia, which can compromise neonatal outcomes. The present study aims to evaluate the effect of preoperative caffeine administration on noradrenaline requirements during spinal anesthesia in obstetric patients. Specifically, the objectives are to compare noradrenaline requirements between the study groups and to assess the incidence of hypotension in both groups.
Eligibility criteria
This trial does not accept healthy volunteersQualifiers
Full-term singleton pregnant (>37 weeks)
ASA II
undergoing elective cesarean section.
Disqualifiers
Patient refusal
SBP < 100 mmHg
Allergy to local anesthetics or caffeine
Coagulopathy (INR>1.4 or platelets <75.000)
Trial design
Parallel
Treatments tested in this trial
Caffeine (200 mg)
DrugPatients will receive 200 mg oral caffeine 30 minutes before spinal anesthesia
Placebo
DrugPatient will receive placebo capsule
Treatment groups
Trial outcomes
Primary outcomes
Average noradrenaline requirement
The total noradrenaline administered as an infusion plus boluses divided by patient weight and infusion time.
Secondary outcomes
Incidence of spinal hypotension
Reduction of systolic blood pressure more than 20% of baseline
Time to first hypotensive episode
Time to develop the first hypotensive episode in minutes
APGAR score
Assessment of APGAR score of neonates
Sponsors and contacts
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