Abstract
Objective
This study aims to evaluate the effects of two strategies for preventing hypotension after spinal anesthesia (prophylactic fluid loading and norepinephrine infusion) on intracranial pressure (ICP) in preeclamptic women by measuring the optic nerve sheath diameter (ONSD) using ultrasound.Methods
In this prospective, randomized, controlled trial, 60 healthy parturients and 60 preeclamptic parturients undergoing cesarean delivery under spinal anesthesia were enrolled. Normal parturients were randomly assigned to the infusion group (NA group, n = 30) and NE (norepinephrine) group (NB group, n = 30), while preeclamptic parturients were randomly assigned to the infusion group (PA group, n = 30) and NE group (PB group, n = 30). The primary outcome was bilateral ONSD values at baseline, pretreatment, 5 min after spinal anesthesia (Post-SA), and 5 min after fetal delivery (Post-birth). The secondary outcomes included maternal general characteristics, renal function indices, postoperative headache, fetal umbilical cord arterial blood gas indices, and Apgar scores.Results
Pretreatment ONSD was significantly higher than baseline in both infusion groups, and baseline ONSD was higher in preeclamptic versus normal parturients (all P PB) confirmed in normal parturients (P 0.05). Conversely, in normal parturients, post-birth SBP, DBP, and MAP were significantly higher in the NB than in the NA group (P 0.05).Conclusion
For preeclamptic parturients, the risks induced by ICP increase should be noted. Compared to colloids, prophylactic infusion of NE was more effective and safer and did not increase ICP.Trial registration
This randomized controlled trial was registered on Chinese Clinical Trial Registry (ChiCTR2400092317; http://www.chictr.org.cn/ ) with the Clinical Trial Registry ({1}).