NCT04025918

Brief Summary

Hypotension occurs commonly during spinal anesthesia for caesarean section with maternal and fetal adverse effects. The investigators developed a double-vasopressor automated system incorporating continuous non-invasive arterial pressure monitoring (CNAP, CNSystems, Austria).

Trial Health

100
On Track

Trial Health Score

Automated assessment based on enrollment pace, timeline, and geographic reach

Enrollment
216

participants targeted

Target at P75+ for phase_2

Timeline
Completed

Started Oct 2011

Shorter than P25 for phase_2

Status
completed

Health score is calculated from publicly available data and should be used for screening purposes only.

Trial Relationships

Click on a node to explore related trials.

Study Timeline

Key milestones and dates

Study Start

First participant enrolled

October 1, 2011

Completed
9 months until next milestone

Primary Completion

Last participant's last visit for primary outcome

July 1, 2012

Completed
Same day until next milestone

Study Completion

Last participant's last visit for all outcomes

July 1, 2012

Completed
7 years until next milestone

First Submitted

Initial submission to the registry

July 17, 2019

Completed
2 days until next milestone

First Posted

Study publicly available on registry

July 19, 2019

Completed
Last Updated

July 19, 2019

Status Verified

July 1, 2019

Enrollment Period

9 months

First QC Date

July 17, 2019

Last Update Submit

July 17, 2019

Conditions

Keywords

hypotensionspinal anesthesiacesarean sectionphenylephrineephedrineclosed-loop systemcontinuous non-invasive monitor

Outcome Measures

Primary Outcomes (1)

  • Hypotension

    Incidence of systolic blood pressure less than 80% of baseline systolic blood pressure

    1 day

Secondary Outcomes (2)

  • Hypertension

    1 day

  • Nausea and vomiting

    1 day

Study Arms (2)

vasopressor delivery automated system

EXPERIMENTAL

vasopressor delivery automated system that administered phenylephrine and ephedrine based on data from continuous non-invasive hemodynamic monitor

Device: Vasopressor automated delivery systemDrug: PhenylephrineDrug: Ephedrine

manual vasopressor delivery

ACTIVE COMPARATOR

manual bolus that delivered phenylephrine and ephedrine based on data from non-invasive intermitted blood pressure monitor

Drug: PhenylephrineDrug: EphedrineDevice: Manual vasopressor delivery system

Interventions

Novel closed-loop system incorporating: 1. Continuous non-invasive arterial pressure (CNAP) monitor that measured and recorded hemodynamic data in real time. 2. Controller algorithm loaded onto a laptop computer that monitored the hemodynamic data from CNAP and determined if vasopressors should be administered. 3. Two syringe pumps loaded with phenylephrine and ephedrine that was activated by the controller algorithm.

Also known as: CNAP
vasopressor delivery automated system

Phenylephrine is a vasopressor drug that was administered when the participant's systolic blood pressure fell below 90% of baseline systolic blood pressure, with heart rate of at least 60bpm.

manual vasopressor deliveryvasopressor delivery automated system

Ephedrine is a vasopressor drug that was administered when the participant's systolic blood pressure fell below 90% of baseline systolic blood pressure, with heart rate of less than 60bpm.

manual vasopressor deliveryvasopressor delivery automated system

Manual dosing system consisting: 1. Non-invasive intermittent blood pressure monitor that measured and recorded blood pressure at 1-minute intervals. 2. Attending anesthesiologist that noted the blood pressure readings and manually administered phenylephrine or ephedrine according to the algorithm.

manual vasopressor delivery

Eligibility Criteria

Age21 Years - 45 Years
Sexfemale(Gender-based eligibility)
Gender Eligibility DetailsStudy participants need to be pregnant and undergoing elective cesarean section
Healthy VolunteersYes
Age GroupsAdult (18-64)

You may qualify if:

  • age 21-45 years old,
  • weight 40-90 kg,
  • height 145-170 cm

You may not qualify if:

  • contraindications to spinal anaesthesia,
  • allergy to drugs used in the study, and
  • those with uncontrolled medical conditions such as hypertension, diabetes mellitus, and cardiovascular disease

Contact the study team to confirm eligibility.

Sponsors & Collaborators

Related Publications (3)

  • Ngan Kee WD. Prevention of maternal hypotension after regional anaesthesia for caesarean section. Curr Opin Anaesthesiol. 2010 Jun;23(3):304-9. doi: 10.1097/ACO.0b013e328337ffc6.

    PMID: 20173633BACKGROUND
  • Sia AT, Tan HS, Sng BL. Closed-loop double-vasopressor automated system to treat hypotension during spinal anaesthesia for caesarean section: a preliminary study. Anaesthesia. 2012 Dec;67(12):1348-55. doi: 10.1111/anae.12000. Epub 2012 Sep 28.

    PMID: 23020653BACKGROUND
  • Sng BL, Tan HS, Sia AT. Closed-loop double-vasopressor automated system vs manual bolus vasopressor to treat hypotension during spinal anaesthesia for caesarean section: a randomised controlled trial. Anaesthesia. 2014 Jan;69(1):37-45. doi: 10.1111/anae.12460. Epub 2013 Nov 20.

MeSH Terms

Conditions

Hypotension

Interventions

PhenylephrineEphedrine

Condition Hierarchy (Ancestors)

Vascular DiseasesCardiovascular Diseases

Intervention Hierarchy (Ancestors)

EthanolaminesAmino AlcoholsAlcoholsOrganic ChemicalsAminesPropanolaminesPropanolsPhenethylaminesEthylamines

Study Officials

  • Ban Leong Sng, FANZCA

    KK Women's and Children's Hospital

    PRINCIPAL INVESTIGATOR

Study Design

Study Type
interventional
Phase
phase 2
Allocation
RANDOMIZED
Masking
TRIPLE
Who Masked
PARTICIPANT, CARE PROVIDER, INVESTIGATOR
Purpose
TREATMENT
Intervention Model
PARALLEL
Sponsor Type
OTHER GOV
Responsible Party
SPONSOR

Study Record Dates

First Submitted

July 17, 2019

First Posted

July 19, 2019

Study Start

October 1, 2011

Primary Completion

July 1, 2012

Study Completion

July 1, 2012

Last Updated

July 19, 2019

Record last verified: 2019-07

Data Sharing

IPD Sharing
Will not share