scholarly journals Effects of Combined Warmed Preoperative Forced-air and Warmed Perioperative Intravenous Fluids on Maternal Temperature During Cesarean Section: a prospective, randomized, controlled clinical trial

2020 ◽  
Author(s):  
tingting Ni ◽  
Zhen-feng Zhou ◽  
Bo He ◽  
Qing-he Zhou
Keyword(s):  
Clinical Trial ◽  
Cesarean Section ◽  
Thermal Comfort ◽  
Core Temperature ◽  
Intervention Group ◽  
Control Group ◽  
Intravenous Fluids ◽  
Cesarean Sections ◽  
The Core ◽  
Forced Air

Abstract Background: Preventing the frequent perioperative hypothermia incidents that occur during elective caesarean deliveries would be beneficial. This trial aimed at evaluating the effect of preoperative forced-air warming alongside perioperative intravenous fluid warming in women undergoing cesarean sections under spinal anesthesia.Methods: We randomly allocated135 women undergoing elective cesarean deliveries to either the intervention group (preoperative forced-air and intravenous fluid warmings, n = 69) or the control group (no active warming, n = 66). The primary outcome measure was the change from the core baseline temperature to that at the end of the procedure. Secondary outcomes included thermal comfort scores, the incidences of shivering and hypothermia (<36℃), the core temperature on arrival at the post-anesthesia care unit, neonatal axillary temperature at birth, and Apgar scores.Results: Two-way repeated measures ANOVA revealed significantly different core temperature changes (from the pre-spinal temperature to that at the end of the procedure) between groups (F = 13.022, P <0.001). The thermal comfort scores were also higher in the intervention group than in the control group (F = 9.847, P = 0.002). The overall incidence of perioperative hypothermia was significantly lower in the intervention group than in the control group (20.6% vs. 51.6%, P <0.0001).Conclusions: Warming preoperative forced-air and perioperative intravenous fluids may prevent maternal hypothermia, reduce maternal shivering, and improve maternal thermal comfort for patients undergoing cesarean sections under spinal anesthesia.Trial registration: The study was registered with the Chinese Clinical Trial Registry (registration number: ChiCTR1800019117) on October26, 2018. Keywords: Cesarean section, Spinal anesthesia, Warming

scholarly journals Effects of Combined Warmed Preoperative Forced-air and Warmed Perioperative Intravenous Fluids on Maternal Temperature During Cesarean Section: a prospective, randomized, controlled clinical trial

2020 ◽  
Author(s):  
tingting Ni ◽  
Zhen-feng Zhou ◽  
Bo He ◽  
Qing-he Zhou
Keyword(s):  
Clinical Trial ◽  
Cesarean Section ◽  
Thermal Comfort ◽  
Spinal Anesthesia ◽  
Intervention Group ◽  
Control Group ◽  
Intravenous Fluids ◽  
Cesarean Sections ◽  
The Core ◽  
Forced Air

Abstract Background: Preventing the frequent perioperative hypothermia incidents that occur during elective caesarean deliveries would be beneficial. This trial aimed at evaluating the effect of preoperative forced-air warming alongside perioperative intravenous fluid warming in women undergoing cesarean sections under spinal anesthesia. Methods: We randomly allocated135 women undergoing elective cesarean deliveries to either the intervention group (preoperative forced-air and intravenous fluid warmings, n = 69) or the control group (no active warming, n = 66). The primary outcome measure was the change from the core baseline temperature to that at the end of the procedure. Secondary outcomes included thermal comfort scores, the incidences of shivering and hypothermia (<36℃), the core temperature on arrival at the post-anesthesia care unit, neonatal axillary temperature at birth, and Apgar scores. Results: Two-way repeated measures ANOVA revealed significantly different core temperature changes (from the pre-spinal temperature to that at the end of the procedure) between groups ( F = 13.022, P <0.001). The thermal comfort scores were also higher in the intervention group than in the control group ( F = 9.847, P = 0.002). The overall incidence of perioperative hypothermia was significantly lower in the intervention group than in the control group (20.6% vs. 51.6%, P <0.0001). Conclusions: Warming preoperative forced-air and perioperative intravenous fluids may prevent maternal hypothermia, reduce maternal shivering, and improve maternal thermal comfort for patients undergoing cesarean sections under spinal anesthesia. Trial registration: The study was registered with the Chinese Clinical Trial Registry (registration number: ChiCTR1800019117) on October26, 2018. Keywords: Cesarean section, Spinal anesthesia, Warming

Efficacy of Two Methods for Reducing Postbypass Afterdrop

2000 ◽  
Vol 92 (2) ◽  
pp. 447-447 ◽  
Author(s):  
Angela Rajek ◽  
Rainer Lenhardt ◽  
Daniel I. Sessler ◽  
Gabriele Brunner ◽  
Markus Haisjackl ◽  
...  
Keyword(s):  
Sodium Nitroprusside ◽  
Core Temperature ◽  
Heat Content ◽  
Tissue Temperature ◽  
Control Group ◽  
Peripheral Tissues ◽  
The Core ◽  
Forced Air Warming ◽  
Forced Air ◽  
Body Heat

Background Afterdrop, defined as the precipitous reduction in core temperature after cardiopulmonary bypass, results from redistribution of body heat to inadequately warmed peripheral tissues. The authors tested two methods of ameliorating afterdrop: (1) forced-air warming of peripheral tissues and (2) nitroprusside-induced vasodilation. Methods Patients were cooled during cardiopulmonary bypass to approximately 32 degrees C and subsequently rewarmed to a nasopharyngeal temperature near 37 degrees C and a rectal temperature near 36 degrees C. Patients in the forced-air protocol (n = 20) were assigned randomly to forced-air warming or passive insulation on the legs. Active heating started with rewarming while undergoing bypass and was continued for the remainder of surgery. Patients in the nitroprusside protocol (n = 30) were assigned randomly to either a control group or sodium nitroprusside administration. Pump flow during rewarming was maintained at 2.5 l x m(-2) x min(-1) in the control patients and at 3.0 l x m(-2) x min(-1) in those assigned to sodium nitroprusside. Sodium nitroprusside was titrated to maintain a mean arterial pressure near 60 mm Hg. In all cases, a nasopharyngeal probe evaluated core (trunk and head) temperature and heat content. Peripheral compartment (arm and leg) temperature and heat content were estimated using fourth-order regressions and integration over volume from 18 intramuscular needle thermocouples, nine skin temperatures, and "deep" hand and foot temperature. Results In patients warmed with forced air, peripheral tissue temperature was higher at the end of warming and remained higher until the end of surgery. The core temperature afterdrop was reduced from 1.2+/-0.2 degrees C to 0.5+/-0.2 degrees C by forced-air warming. The duration of afterdrop also was reduced, from 50+/-11 to 27+/-14 min. In the nitroprusside group, a rectal temperature of 36 degrees C was reached after 30+/-7 min of rewarming. This was only slightly faster than the 40+/-13 min necessary in the control group. The afterdrop was 0.8+/-0.3 degrees C with nitroprusside and lasted 34+/-10 min which was similar to the 1.1+/-0.3 degrees C afterdrop that lasted 44+/-13 min in the control group. Conclusions Cutaneous warming reduced the core temperature afterdrop by 60%. However, heat-balance data indicate that this reduction resulted primarily because forced-air heating prevented the typical decrease in body heat content after discontinuation of bypass, rather than by reducing redistribution. Nitroprusside administration slightly increased peripheral tissue temperature and heat content at the end of rewarming. However, the core-to-peripheral temperature gradient was low in both groups. Consequently, there was little redistribution in either case.

scholarly journals The Effect of Oketani Breast Massage on Successful Breastfeeding, Mothers’ Breastfeeding Support Need, and Breastfeeding Self-Efficacy: A Clinical Trial Study

2020 ◽  
Author(s):  
Maryam Mahdizadeh Shahri ◽  
Manijeh Nourian ◽  
Maryam Varzeshnejad ◽  
Maliheh Nasiri
Keyword(s):  
Clinical Trial ◽  
Success Rate ◽  
Self Efficacy ◽  
Assessment Tool ◽  
Intervention Group ◽  
Onset Time ◽  
Control Group ◽  
Time Interval ◽  
Cesarean Sections ◽  
Need For Support

Abstract Background: The most important factor in the survival and health of infants is breastfeeding. One of the complications of cesarean sections is their negative effect on the quality of breastfeeding. This study aimed to determine the effect of Oketani breast massage on the maternal need for support during breastfeeding, breastfeeding success, and breastfeeding selfefficacy. Methods: The research sample in this clinical trial study included pregnant women who referred to Mahdiyeh, Taleghani, and Imam Hossein hospitals as candidates for a cesarean section. The mothers were selected using convenience sampling and randomly assigned to the intervention group (n = 55) and the control group (n = 58). The data were collected using, the Infant Breastfeeding Assessment Tool (IBFAT), the Breastfeeding Charting System (LATCH), and the Breastfeeding Self-Efficacy Scale (BSES). To assess the breastfeeding success rate, the number of breastfeeding times, and the onset time of the first breastfeeding were recorded. The collected data were analyzed using SPSS software (version 20) via the independent samples t-test, the Mann–Whitney U test, and chi-square test. Results: The results of the study suggested that the breastfeeding success rate in both the first two breastfeeding stages and the last pre-discharge breastfeeding was significantly higher for the participants in the intervention group than the members of the control group (p <0.001). Besides, the mother's need for support in the first two breastfeeding stages (p = 0.044) and the last pre-discharge breastfeeding (p <0.001) in the intervention group was less than that of the mothers in the control group. The number of breastfeeding in the intervention group was higher than the control group (p = 0.002). Furthermore, the mothers in the intervention group breastfed their infants in a significantly less time interval (p = 0.002). The breastfeeding self-efficacy was significantly higher in the intervention group than in the control group (p <0.001). Conclusion: Oketani massage can be used as a care intervention by nurses to improve breastfeeding in mothers who undergo cesarean sections and have more breastfeeding problems. Trial registration Iranian Registry of Clinical Trials (IRCT): IRCT20190129042542N1.

scholarly journals Eremostachys laciniata as effective as rectal diclofenac suppository in cesarean section pain relief: A triple-blind controlled clinical trial

2020 ◽  
Vol 12 (1) ◽  
pp. 26-34
Author(s):  
Shabnam Mohammad Pour ◽  
Sevil Hakimi ◽  
Abbas Delazar ◽  
Yousef Javad Zadeh ◽  
Fatemeh Mallah
Keyword(s):  
Clinical Trial ◽  
Cesarean Section ◽  
Intervention Group ◽  
Massive Hemorrhage ◽  
Control Group ◽  
Controlled Clinical Trial ◽  
Total Extract ◽  
Significant Difference ◽  
Healing Score ◽  
Distress Scale

Background: Pain and distress are two common complications of cesarean section. Among complementary therapies, Eremostachys was introduced as a pain mitigator. This study aimed at investigating the effect of Eremostachys laciniata on cesarean section pain and distress. Materials and methods: This randomized clinical trial was conducted on 86 women who gave childbirth by cesarean section. The control group received 50 mg rectal diclofenac suppository every 8 h for 3 days, and the intervention group received 35 mg E. laciniata total extract suppository every 8 h up to three doses. Pain was measured with the Visual Analogue Scale at 8, 16, and 24 h after cesarean section. The Symptom Distress Scale was completed at 8 and 24 h after cesarean section. The Redness, Edema, Ecchymosis, Discharge, Approximation scale was completed 5 days after cesarean section. Findings: Pain score at 8, 16, and 24 h after surgery (15 min after intervention) was not significantly different between the intervention and control groups. The distress score 24 h after cesarean section showed a significant difference in favor of the control group according to Friedman’s test. There was a significant difference between the two groups in wound healing score, which indicated better efficacy of rectal diclofenac suppository than E. laciniata suppository. We assessed nausea, vomiting, headache, massive hemorrhage, and any type of anaphylactic reaction. No side events were observed in two groups. Conclusion: Rectal E. laciniata suppository could be introduced as a low-complication, appropriate, and effective medication in controlling pain and distress after cesarean section; more studies should be conducted on this matter.

Effect of chamomile oil on cesarean section pain in primiparous women: a randomized clinical trial

2020 ◽  
Vol 15 ◽  
Author(s):  
Roghayeh Zardosht ◽  
Ameneh Basir ◽  
Amirhossein Sahebkar ◽  
Seyed Ahmad Emami
Keyword(s):  
Clinical Trial ◽  
Cesarean Section ◽  
Pain Intensity ◽  
Intervention Group ◽  
Control Group ◽  
Post Intervention ◽  
Chi Square ◽  
Double Blind ◽  
The Difference ◽  
Primiparous Women

Background: Pain after cesarean section can turn the pleasant event of childbirth into an unpleasant experience for the mother. Pain relief through non-pharmaceutical methods, such as aromatherapy, could potentially be a useful intervention. In this study, the analgesic effect of chamomile oil was studied. Purpose: The current research was conducted to study the effect of chamomile oil on cesarean section pain in primiparous women. Materials and methods: This was a randomized double blind clinical trial wherein 128 primiparous pregnant women (who willingly selected cesarean section) took part. In the aromatherapy group, the subjects inhaled one drop of 5% chamomile oil, and in the control group the subjects inhaled one placebo drop. In both groups the subjects inhaled for 15-20 minutes at a distance of 5 cm from the nose at 4, 8, and 12 hours after surgery, and pain intensity was measured before and after half an hour after inhalation using the visual analog scale (VAS). For data analysis, the software SPSS (version 25) and descriptive statistics (frequency, frequency percentage, mean, and standard deviation) were used. In order to determine the significance, inferential statistics (Mann-Whitney, Wilcoxon, independent t-test, and Chi-square) were used. Findings: Data indicated that the intervention and placebo groups were homogeneous in terms of demographic variables. The average weights and heights of women in the intervention group were 86/5± 5/9 and 163/7 ±5/1, respectively. Corresponding values women in the control group were 84/5± 5/7 kg and 163/4± 5/8 cm. The finding of the current research indicates that the intervention and placebo groups showed no significant statistical difference in terms of baseline pain before intervention (p=0.08), while the difference between the two groups was significant in terms of pain 4, 8, and 12 hours after intervention (p<0.01). Therefore, inhalation of chamomile oil reduced pain intensity significantly compared to post-intervention. Conclusion: According to the results of the present study, inhalation of chamomile oil following caesarean section in primiparous women reduced pain and also the need for analgesics. Therefore, the use of aromatherapy with chamomile oil as a simple way without any side effects for the reduction of pain in mothers after cesarean section is recommended.

scholarly journals Comparative study of surgical site infection with or without post cesarean prophylactic oral antibiotics; a single-blinded randomized clinical trial

2021 ◽  
Vol 7 (1) ◽  
pp. e07-e07
Author(s):  
Farzaneh Broumand ◽  
Naghmeh Zand Vakili ◽  
Zahra Yekta ◽  
Shabnam Vazifekhah
Keyword(s):  
Clinical Trial ◽  
Cesarean Section ◽  
Surgical Site Infection ◽  
Intervention Group ◽  
Prophylactic Antibiotic ◽  
Maternal Diabetes ◽  
Deep Infection ◽  
Control Group ◽  
Site Infection ◽  
Emergency Cesarean

Introduction: Surgical site infection (SSI) is caused by cesarean section in the hospital and its prevalence in the studies is up to 16%. Objectives: This study aimed to compare the rate of infection in women undergoing cesarean section. Oral clindamycin and cefalexin were administered for 48 hours as prophylactic antibiotics. Patients and Methods: In this clinical trial study, women with emergency cesarean section were divided into two groups. Intervention was oral administration of cefalexin 500mg every 6 hours and clindamycin 300 mg every 6 hours for 48 hours. All participants were referred to the gynecology center on day 7–10, at the time of removal of the sutures, and within 30 days after cesarean section, to assess the presence or absence of wound infection after surgery during 30 days. Results: In this clinical trial study, 462 pregnant women undergoing cesarean section were enrolled in the intervention and control groups. Of 231 patients in the intervention group, 15 women (6.5%) had cesarean section infection (13 cases with superficial, and 2 cases with deep infection). In the control group, 45 cases (19.5%) had cesarean section infection (31 cases with superficial, 10 cases with deep, and 4 cases with developed pelvic infection) (P = 0.001). Age, pre-cesarean length of stay, pre-term incision, type of incision, discharge longer than 18 hours after cesarean section, and maternal diabetes were significantly different regarding cesarean section infection in both groups. The frequency of cesarean section infection was less in the intervention group (P <0.001). Conclusion: Administration of prophylactic antibiotic can have a significant role in reducing cesarean section infection. Trial Registration: Registration of trial protocol has been approved in Thailand registry of clinical trials (identifier: TCTR20201204002, http://www.clinicaltrials.in.th/index.php?tp=regtrials & menu=trialsearch & s-menu=fulltext & task=search & task2=view1 & id=7120, ethical code; IR.UMSU.REC.1397.323).

Investigation of the Effect of Operating Room Environment and Cesarean Section Orientation on Physiological Parameters (BP, heart rate, respiration) in Mothers of Candidate for Cesarean Section in Shiraz, a Clinical Trial Study

2021 ◽  
Vol 17 ◽  
Author(s):  
Jamshid Eslami ◽  
Neda Hatami ◽  
Aazadeh Amiri ◽  
Marzieh Akbarzadeh
Keyword(s):  
Blood Pressure ◽  
Clinical Trial ◽  
Heart Rate ◽  
Cesarean Section ◽  
Pregnant Women ◽  
Operating Room ◽  
Intervention Group ◽  
Physiological Parameters ◽  
Control Group ◽  
The Mean

Background: : Changes in physiological parameters in pregnant women are important factors in mothers who are candidates for cesarean section. Objective:: The aim of present study was to investigate the effect of operating room and cesarean section orientation on the physiological parameters (BP, heart rate, respiration) of pregnant women undergoing cesarean section. Materials and Methods:: This clinical trial study was performed on 80 pregnant women referring to cesarean section in hospitals affiliated to Shiraz University of Medical Sciences in 2019. The samples were randomly divided into two control (n = 40) and intervention groups (n = 40). The intervention group participated in 4 sessions of training classes. The control group used routine hospital trainings. The parameters were measured before and after the intervention in two groups. Data were analyzed using SPSS software (version 21), independent t-test and analysis of covariance. Results: The mean of post-training blood pressure in the intervention group 82.78(7.86) and in the control group 84.08 (7.44) was not statistically significant (p < .487). After intervention, the mean of heart rate in the intervention group 82.15 (8.10) and in the control group 83.43 (8.54) was statistically significant (p <0.0001). After intervention, the mean of respiratory rate in the intervention group was 94.28 (0.96) and in the control group was 75.96 (1.08) (P <0.0001). Conclusions: Although the patient's operating room and cesarean section orientation did not affect mothers' mean blood pressure; it reduced the mean of their heart rate and respiratory rate. It is important for medical staff to play an important role in identifying important strategies in managing the anxiety of pregnant women in order to improve their physiological indicators.

Efficacy of Aloe vera/ Plantago Major Gel in Diabetic Foot Ulcer: A Randomized Double-Blind Clinical Trial

2019 ◽  
Vol 16 (2) ◽  
pp. 223-231 ◽  
Author(s):  
Younes Najafian ◽  
Zahra M. Khorasani ◽  
Mona N. Najafi ◽  
Shokouh S. Hamedi ◽  
Marjan Mahjour ◽  
...  
Keyword(s):  
Clinical Trial ◽  
Diabetic Foot ◽  
Intervention Group ◽  
Aloe Vera ◽  
Foot Ulcer ◽  
Diabetic Foot Ulcer ◽  
Control Group ◽  
Plantago Major ◽  
Double Blind ◽  
Significant Difference

Background:Diabetic foot ulcer (DFU) is one of the most common complications of diabetic patients. Mostly, non-healing DFU leads to infection, gangrene, amputation and even death. High costs and poor healing of the wounds need a new treatment such as alternative medicine. So, the aim of this study was to evaluate the efficacy of Aloe vera/ Plantago major gel (Plantavera gel) in healing of DFUMethods:Forty patients with DFU enrolled in a double-blind randomized clinical trial. The patients who were randomly assigned into the intervention group (n = 20), received topical Plantavera gel in addition to the routine cares, whereas the patients in the control group (n = 20), received topical Placebo gel in addition to the routine cares. Intervention was done twice a day for 4 weeks in the both groups. Photography and an evaluation of DFU healing were conducted by a checklist and then were scored at baseline and at the end of each week. The collected data was analyzed by SPSS software.Results:At the end of the study, there was a significant difference between the two groups in terms of total ulcer score (P<0.001) and Plantavera gel significantly reduced the ulcer surface comparing with the control group (P=0.039). However, there was not a significant difference between the two groups (P=0.263) in terms of the ulcer depth. During this study, no side effect was observed for Plantavera gel in the intervention group.Conclusion:Topical Plantavera gel seems to be an effective, cheap and safe treatment. Of course, further studies are required to confirm the properties of the wound healing of this gel.

scholarly journals Effect of leg wrapping technique on prevention of spinal induced hypotension and fetal acidosis during cesarean section: Randomized controlled trial

2019 ◽  
Vol 10 (2) ◽  
pp. 70
Author(s):  
Samah Nasser Abd El-Aziz El-Shora ◽  
Amina Mohamed Rashad El-Nemer
Keyword(s):  
Randomized Controlled Trial ◽  
Cesarean Section ◽  
Controlled Trial ◽  
Intervention Group ◽  
Cost Effective ◽  
Control Group ◽  
Induced Hypotension ◽  
Randomized Controlled ◽  
Significant Difference ◽  
Wrapping Technique

Background and aim: Hypotension during cesarean section (CS) under spinal anesthesia has been a subject of scientific study for more than 50 years and the search for the most effective strategy to achieve hemodynamic stability remains challenging. Aim: The study was carried out to apply leg wrapping technique for the prevention of spinal-induced hypotension (SIH) during CS.Methods: Randomized Controlled Trial design was utilized at cesarean delivery operating room Mansoura General Hospital in El-Mansoura City during the period from May 2018 to November 2018. A purposive sample of 88 pregnant women, assigned randomly to an intervention group (n = 44) in which their legs wrapped with elastic crepe bandage and control group (n = 44) in which no wrapping was done. Data collected for maternal, neonatal hemodynamic and signs of hypotension, the feasibility of application and cost analysis.Results: There was a statistically significant difference in the incidence of SIH and Ephedrine use among both groups (18.20% in leg wrapping group whereas 75% in control group). In addition, neonatal acidosis and NICU admission were less among leg wrapping group (11.40%, 9.10% respectively). Economically, leg wrapping technique was cost effective compared to the cost of the hospital regimen for treating SIH and admission to (NICU).Conclusion and recommendations: Leg wrapping technique was cost effective and an efficient method for decreasing SIH, neonatal acidosis and Ephedrine administration. It is recommended to apply leg wrapping technique in maternal hospitals' protocol of care for decreasing SIH during CS.

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