Prediction of Hypotension and Postdural Puncture Headache by Carotid Artery Corrected Flow Time

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Conditions studied: Hypotension in Pregnant Women, Headache in Pregnant Women

In brief

Anesthesia for cesarean delivery can be provided through general or neuraxial anesthesia (spinal or epidural). Hypotension is a common complication of both methods. Hypotension associated with spinal anesthesia can cause dizziness, nausea, vomiting, restlessness, and confusion in the mother, while also decreasing blood flow to the baby, leading to hypoxia and fetal acidosis. Untreated persistent hypotension poses a life-threatening risk to both mother and baby. In recent years, ultrasonography has become widely used to assess volume status. Carotid artery corrected flow time (FTc) is primarily affected by left ventricular preload and is related to myocardial contractility and afterload. Therefore, it can predict intraoperative hypotension. Postdural puncture headache (PDPH) is a relatively common complication after neuraxial blocks. PDPH is generally defined as an orthostatic headache caused by low cerebrospinal fluid pressure accompanied by neck pain, tinnitus, hearing changes, photophobia, and/or nausea. Risk factors include female gender, young age, pregnancy, a previous history of PDPH, low CSF pressure, and low BMI. This study will be conducted on pregnant women undergoing elective cesarean sections under spinal anesthesia in the cesarean operating room at Erciyes University Faculty of Medicine Hospital. The correlation between preoperative carotid artery FTc levels in pregnant women and the incidence of intraoperative hypotension and postoperative PDPH will be investigated, as will whether FTc levels are a significant predictor of the likelihood of developing intraoperative hypotension and postoperative PDPH. Carotid artery FTc will be measured 1 hour before surgery, and baseline systolic blood pressure (SBP), diastolic blood pressure (DBP), mean arterial pressure (MAP), peripheral oxygen saturation (SPO2), and heart rate will be recorded in the operating room. Values will be recorded at 1, 2, 3, 5, 10, 12, 15, and 30 minutes after spinal anesthesia. Patients will be assessed postoperatively for postdural puncture headache using a numerical rating scale (NRS) on days 2, 3, and 7. This study is expected to demonstrate the ability of preoperative FTc to predict hypotension and PDPH, to determine the threshold value for predicting hypotension and PDPH, and to improve or modify the anesthesia method in patients with predicted hypotension and PDPH.

Key facts

Study ID

NCT07372313

Run by

TC Erciyes University

People needed

90

Starts

2026-02-15

Expected to finish

2027-04-15

Last updated by the study team

2026-01-28

Who can join

Age: 18 and older, up to 49. Sex: female. Healthy volunteers: not accepted.

You may qualify if…

• American Society of Anesthesiologists (ASA) Class II
• Regular antenatal visits
• Singleton pregnancy at ≥37 weeks' gestation
• Pregnant women aged 18-49

You may not qualify if…

• Patients with eclampsia or preeclampsia
• Patients who have undergone emergency cesarean section
• Patients with bleeding diatheses and those receiving anticoagulant therapy
• Patients with a history of ≥50% carotid artery stenosis
• Patients with cardiovascular disease
• Hypertension
• Patients with chronic obstructive pulmonary disease
• Patients with a heart rhythm other than sinus rhythm
• Patients with a history of cerebrovascular disease
• Patients with alcoholism or psychiatric illness
• Patients with placenta previa, accreta, or percreta
• Patients with diabetes

Full record on ClinicalTrials.gov

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