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

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 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.

scholarly journals Pre-delivery Conscious Sedation with Intravenous Low Dose Thiopental Na Bolus during Spinal Anesthesia for Cesarean Section

2019 ◽  
Author(s):  
Masoomeh Nataj Majd ◽  
Nasrin Faridi Tazeh-kand ◽  
Ladan Hoseini ◽  
Mahdi Sepidarkish
Keyword(s):  
Cesarean Section ◽  
Spinal Anesthesia ◽  
Low Dose ◽  
Conscious Sedation ◽  
Group Iv ◽  
Control Group ◽  
Clinical Effects ◽  
Cesarean Sections ◽  
Physical Status ◽  
Level Of Consciousness

Background: Nowadays, according to the large number of cesarean sections under spinal anesthesia, finding a simple and safe pre-delivery sedation technique which provides satisfaction for mothers with no over sedation and amnesia seems to be necessary. However, there is not enough evidence about the best choice of drug for this purpose. In the present study we aimed in evaluating the clinical effects of different concentrations (0.25, 0.5, 0.75mg/kg) of thiopental Na bolus for the mother’s satisfaction in cesarean section under spinal anesthesia. Methods: Two hundred and forty term singleton pregnant women with normal ASA physical status were scheduled for an elective term cesarean delivery under spinal anesthesia and allocated into four groups. Groups I, II, III received 0.25, 0.5, 0.75mg/kg/IV of Thiopental Na respectively and group IV as the control group received 1.5cc of sterile water,1 min after spinal anesthesia. The level of consciousness with observer assessment of alertness/sedation score (OAA/S) and mother’s satisfaction was considered as primary outcomes. Results: The level of mothers’ satisfaction in group II was significantly higher than other groups without any over sedation (P<0.001) and no adverse effect on their verbal contact was observed and they could easily communicate. All women could remember their infants. All babies were healthy with no complications and the Apgar scores were the same in all studied groups. Conclusion: Based on the results of the present study and with comparison of different concenfrations and side effects indicates pre-delivery conscious sedation with 0. 5 mg/kg/IV of Thiopental Na could be a safe and appropriate technique for sedation in cesarean sections surgery under spinal anesthesia.

scholarly journals Educational intervention with serial album about pregnant women positioning for spinal anesthesia: randomized clinical trial

2020 ◽  
Vol 73 (suppl 4) ◽  
Author(s):  
Sarah de Lima Pinto ◽  
Larissa Alves Sampaio ◽  
Nelson Miguel Galindo Neto ◽  
Paulo César de Almeida ◽  
Mirna Fontenele de Oliveira ◽  
...  
Keyword(s):  
Clinical Trial ◽  
Pregnant Women ◽  
Spinal Anesthesia ◽  
Randomized Clinical Trial ◽  
Educational Intervention ◽  
Intervention Group ◽  
Maternity Hospital ◽  
Control Group ◽  
Chi Square ◽  
Exact Test

ABSTRACT Objective: To evaluate effectiveness of using educational intervention serial album to positioning pregnant women for spinal anesthesia. Method: Randomized clinical trial with 90 women casually assigned to control (CG) and intervention group (IG), in a maternity hospital located in Northeast region of Brazil. The primary endpoint was “achieve correct positioning to perform spinal anesthesia”; and secondary, “how number of spinal cord puncture attempts”. Effectiveness was verified using the chi-square test, Fisher’s exact test and likelihood ratio. Results: The positioning was correct in 37 women in each group. There was an association between women in control group remaining still, relaxing shoulders and flexing the spine; and women in intervention group should remain still and relax the shoulders; furthermore there was a statistical association achieved by correct positioning and the number of attempts to access the lumbar puncture. Conclusion: Educational intervention with serial album was effective and contributed to immobility and positioning of pregnant women. Brazilian Registry of Clinical Trials (RBR-3Z7SRD).

scholarly journals Comparative Study of Effect of Spinal Anesthesia in Sitting and Lateral Positions on the Onset Time of Sensory Block and Hemodynamic Condition in Cesarean Section: A Randomized Clinical Trial

2021 ◽  
Vol 11 (1) ◽  
Author(s):  
Nahid Manouchehrian ◽  
Abbas Moradi ◽  
Leyla Torkashvand
Keyword(s):  
Clinical Trial ◽  
Cesarean Section ◽  
Spinal Anesthesia ◽  
Motor Block ◽  
Onset Time ◽  
Sensory Block ◽  
Lateral Position ◽  
Sitting Position ◽  
Cesarean Sections ◽  
Position Group

Background: Spinal anesthesia is the method of choice for the cesarean section. Hypotension is a common complication of this method. Objectives: This study aimed to compare the effect of spinal anesthesia in the sitting and lateral positions on the onset time of sensory block and hemodynamic condition in cesarean sections. Methods: In this clinical trial, 106 elective cesarean section candidates under spinal anesthesia were selected and randomly divided into two groups: spinal anesthesia in the sitting position (group S) and the lateral position (group L). The onset time of the sensory block, quality of sensory and motor block, hemodynamic condition, frequency of hypotension, nausea, and vomiting, and the doses of ephedrine and atropine were compared between both groups. Data were analyzed with SPSS version 16 software at a 95% confidence level. Results: There was no statistically significant difference between the two groups in terms of age. The frequency of hypotension in L and S groups was 24.5% and 57.7%, respectively (P = 0.001), in minute 6 after spinal anesthesia and 5.7% and 36.5%, respectively (P < 0.001), in minute 8 after spinal anesthesia. The mean time to reach the sensory level of T6 was 1.30 ± 0.43 min versus 4.54 ± 2.12 min (P < 0.001), motor block score in minute 5 was 2.98 ± 0.14 versus 2.82 (P = 0.044), and ephedrine dose was 11.5 mg and 16.92 mg in the L and S groups, respectively (P = 0.010). The maximum sensory-motor block and satisfaction of women with spinal anesthesia were significantly higher in the lateral position than in the sitting position (P < 0.05). Conclusions: Cesarean sections under spinal anesthesia in the lateral position than in the sitting position lead to a more rapid sensory and motor block, reduced ephedrine consumption, and enhanced satisfaction of women.

scholarly journals A Clinical Trial on the Effects of Different Regimens of Phenylephrine on Maternal Hemodynamic After Spinal Anesthesia for Cesarean Section

2020 ◽  
Vol 10 (4) ◽  
Author(s):  
Mahshid Nikooseresht ◽  
Mohammad Ali Seifrabiei ◽  
Pouran Hajian ◽  
Shadab Khamooshi
Keyword(s):  
Blood Pressure ◽  
Clinical Trial ◽  
Cesarean Section ◽  
Spinal Anesthesia ◽  
Cesarean Delivery ◽  
Saline Control ◽  
Control Group ◽  
Significant Difference ◽  
The Mean ◽  
Phenylephrine Infusion

Background: Phenylephrine is used to prevent and treat hypotension during spinal anesthesia for cesarean delivery. Objectives: The present study aims to investigate the effects of different regimens of phenylephrine on blood pressure of candidates for the cesarean section. Methods: In this double-blind, randomized clinical trial, a total of 120 candidates of elective cesarean delivery under spinal anesthesia was randomly categorized into three groups. Groups 1, 2, and 3 received bolus and prophylactic saline (control group), prophylactic bolus phenylephrine (100 µg), and prophylactic phenylephrine infusion (50 µg/min), respectively. The incidence of hypotension, maternal hemodynamics, hypertension, rescue phenylephrine dose, nausea, and vomit were compared between the groups. Results: In all the three groups, the incidence of nausea and vomit, bradycardia, hypertension, and neonatal Apgar score were not statistically different (P > 0.05). However, the adjuvant phenylephrine dose requirement was remarkably different. Moreover, the mean systolic blood pressure differed significantly in the second and 7th minutes after the spinal block (P < 0.05). 35% in the first group, 15% in the second group, and 2.5% in the third group had hypotension (P = 0.001). Apart from the first measurement after spinal anesthesia, the mean heart rate showed no significant difference between the groups. Conclusions: The use of prophylactic phenylephrine infusion is recommended to control the optimal blood pressure in parturients undergoing cesarean section after spinal anesthesia.

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).

scholarly journals Effect of vitamin C on the incidence and severity of postdural puncture headache in patients undergoing cesarean section with spinal anesthesia

2021 ◽  
Vol 43 (1) ◽  
pp. 55-60
Author(s):  
Sepehr Eslami ◽  
Mina Shakeri
Keyword(s):  
Vitamin C ◽  
Cesarean Section ◽  
Spinal Anesthesia ◽  
Normal Saline ◽  
Intervention Group ◽  
Control Group ◽  
Significant Difference ◽  
Group 2 ◽  
Positive Effect ◽  
Group 1

Background: Some studies have shown that vitamin C has a positive effect on reducing headaches after spinal anesthesia, but studies in this field are inadequate. The aim of this study was to determine the effect of vitamin C infusion on the decrease of headache after spinal anesthesia in cesarean section. Methods: This clinical trial study was performed on 160 patients undergoing cesarean section referred to Kowsar Hospital of Yazd in 2017. The patients were randomly divided into two groups including group 1, 2 gr of vitamin C in 500 cc normal saline, and group 2, 500 cc of normal saline was injected preoperatively. The two groups were compared for headache incidence. Results: At the time of recovery, 2 hours later, the frequency of headache in the intervention group was significantly lower than the control group (P <0.05). But there was no significant difference between the two groups regarding headache at 4, 6, 12, 24, and 48 hours postoperatively (P>0.05). Conclusion: Considering the patient's condition, and according to the anesthesiologist and surgeon, vitamin C can be used to reduce pain in patients undergoing cesarean section with spinal anesthesia.

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