<clinical_study>
  <!-- This xml conforms to an XML Schema at:
    https://clinicaltrials.gov/ct2/html/images/info/public.xsd -->
  <required_header>
    <download_date>ClinicalTrials.gov processed this data on September 20, 2023</download_date>
    <link_text>Link to the current ClinicalTrials.gov record.</link_text>
    <url>https://clinicaltrials.gov/ct2/show/NCT03834454</url>
  </required_header>
  <id_info>
    <org_study_id>IndonesiaUAnes027</org_study_id>
    <nct_id>NCT03834454</nct_id>
  </id_info>
  <brief_title>Bupivacaine 5 mg vs 7.5 mg for Spinal Anesthesia in Cesarean Delivery in Indonesian Population</brief_title>
  <official_title>How Low Can we go: A Double-blinded Randomized Controlled Trial to Compare Bupivacaine 5 mg and Bupivacaine 7.5 mg for Spinal Anesthesia in Cesarian Delivery in Indonesian Population</official_title>
  <sponsors>
    <lead_sponsor>
      <agency>Indonesia University</agency>
      <agency_class>Other</agency_class>
    </lead_sponsor>
  </sponsors>
  <source>Indonesia University</source>
  <oversight_info>
    <has_dmc>Yes</has_dmc>
    <is_fda_regulated_drug>No</is_fda_regulated_drug>
    <is_fda_regulated_device>No</is_fda_regulated_device>
  </oversight_info>
  <brief_summary>
    <textblock>
      This study aims to evaluate the efficacy of hyperbaric 5 mg bupivacaine + fentanyl 25 mcg&#xD;
      versus hyperbaric 7.5 mg bupivacaine + fentanyl 25 mcg to lower incidence of hypotension&#xD;
    </textblock>
  </brief_summary>
  <detailed_description>
    <textblock>
      Approval from Ethical Committee of Faculty of Medicine Universitas Indonesia was acquired&#xD;
      prior conducting the study. Subjects will be recruited using consecutive sampling method.&#xD;
      Sample size was determined using alpha 5%, power 80%, and the difference of the incidence of&#xD;
      hypotension 20%. The sample of each group is 56 patients. The investigators will use ECG,&#xD;
      blood pressure monitoring, and pulse oxymetry for the standard monitoring. Patients will be&#xD;
      given oxygen 3 L/minute via nasal cannula. Before the spinal anesthesia, patients will be&#xD;
      given co-loading 500 ml of Ringer Lactate. Patients will be in sitting position while the&#xD;
      lumbal puncture is conducted using 27G Quincke in the level of L3-4 or L4-5 or Tuffier's&#xD;
      line. After ensuring that the tip of the needle is in the subarachnoid space, the drug will&#xD;
      be administered with the speed of 0.2 mL/s. All the procedure will be conducted in sterile&#xD;
      condition. Patients will receive ketoprofen suppositoria as the postoperative analgesia and&#xD;
      can be discharged to the ward when the Aldrete's score is more than 8.&#xD;
&#xD;
      The onset of sensoric blockade is assessed using pinprick test until the level of T6 or&#xD;
      maximum until 20 minute. The peak value will be recorded. The motor blockade will be assessed&#xD;
      using the Bromage scale. Incision will be done when the level of sensory block reached T6. If&#xD;
      patients report pain after delivery of the baby, intravenous fentanyl 0,67-1 mcg/kg will be&#xD;
      given twice with the interval of 10 minutes. If pain persists, conversion to general&#xD;
      anesthesia will be conducted.&#xD;
&#xD;
      The measurement of blood pressure, heart rate, respiratory rate, temperature, and O2&#xD;
      saturation will be recorded during the minute of 3, 6, 9, 12, 15, 20, 30, 40, 50, and 60&#xD;
      after the spinal anesthesia is administered or until the baby is delivered. Patients will be&#xD;
      recorded as hypotensive when she experienced reduction of blood pressure more than 30% from&#xD;
      baseline or systolic pressure less than 100 mmHg from the moment the spinal anesthesia is&#xD;
      administered until the baby is delivered. If the systolic pressure is less than 90 mmHg,&#xD;
      patient will be given ephedrine 5 mg iv that is repeated every minute until the systolic&#xD;
      pressure is over 90 mmHg.&#xD;
&#xD;
      The duration of the surgery is also recorded. Nausea, vomiting, syncope, dizziness, chest&#xD;
      discomfort, and other intraoperative complaint will be recorded. Postoperative nausea and&#xD;
      vomiting, itching, shivering, back pain, Post Dural Puncture Headache (PDPH), and Transient&#xD;
      Neurologic Symptoms (TNS) will also be recorded.&#xD;
    </textblock>
  </detailed_description>
  <overall_status>Completed</overall_status>
  <start_date type="Actual">October 1, 2013</start_date>
  <completion_date type="Actual">December 31, 2013</completion_date>
  <primary_completion_date type="Actual">December 31, 2013</primary_completion_date>
  <phase>N/A</phase>
  <study_type>Interventional</study_type>
  <has_expanded_access>No</has_expanded_access>
  <study_design_info>
    <allocation>Randomized</allocation>
    <intervention_model>Parallel Assignment</intervention_model>
    <primary_purpose>Supportive Care</primary_purpose>
    <masking>Double (Participant, Investigator)</masking>
    <masking_description>Simple randomization will be conducted using a software by one of the researchers (HA) into two groups with equal size. To ensure the concealment, the randomization list will be kept in a sealed enveloped and opened by the physician who administered the spinal anesthesia just before the surgery. Data recording will be conducted by independent observers. This is a double-blinded study for the subjects and for the observers. The enrollment of the participants will be conducted by HA. Patients will not be notified about the dose scheme. Physician who performed the spinal anesthesia are different from the observers. Observers are junior residents trained to test the spinal adequacy and to perform monitoring in spinal anesthesia. It us not possible to blind the physicians who perform the spinal anesthesia because they will notice the volume difference.</masking_description>
  </study_design_info>
  <primary_outcome>
    <measure>Incidence of hypotension</measure>
    <time_frame>60 minutes</time_frame>
    <description>recorded during the minute of 3, 6, 9, 12, 15, 20, 30, 40, 50, and 60 after the spinal anesthesia will be administered or until the baby is delivered</description>
  </primary_outcome>
  <secondary_outcome>
    <measure>Adequacy of Anesthesia</measure>
    <time_frame>120 minutes</time_frame>
    <description>Requirement of additional local anesthetics</description>
  </secondary_outcome>
  <secondary_outcome>
    <measure>Quality of anesthesia: as reported by patients and surgeons</measure>
    <time_frame>120 minutes</time_frame>
    <description>Quality of anesthesia as reported by patients and surgeons</description>
  </secondary_outcome>
  <secondary_outcome>
    <measure>Motor recovery</measure>
    <time_frame>10 hours</time_frame>
    <description>Duration of motor recovery after surgery</description>
  </secondary_outcome>
  <number_of_arms>2</number_of_arms>
  <enrollment type="Actual">112</enrollment>
  <condition>Cesarean Section</condition>
  <condition>Hypotension Drug-Induced</condition>
  <condition>Spinal Anesthesia</condition>
  <condition>Postoperative Complications</condition>
  <arm_group>
    <arm_group_label>Bupivacaine 5 mg</arm_group_label>
    <arm_group_type>Active Comparator</arm_group_type>
    <description>5 mg hyperbaric bupivacaine 0.5% and 25 mcg fentanyl for spinal anesthesia</description>
  </arm_group>
  <arm_group>
    <arm_group_label>Bupivacaine 7.5 mg</arm_group_label>
    <arm_group_type>Active Comparator</arm_group_type>
    <description>7.5 mg hyperbaric bupivacaine 0.5% and 25 mcg fentanyl for spinal anesthesia</description>
  </arm_group>
  <intervention>
    <intervention_type>Drug</intervention_type>
    <intervention_name>Bupivacaine</intervention_name>
    <description>5 mg hyperbaric bupivacaine 0.5% and 25 mcg fentanyl for spinal anesthesia</description>
    <arm_group_label>Bupivacaine 5 mg</arm_group_label>
    <other_name>5 mg hyperbaric bupivacaine 0.5%</other_name>
  </intervention>
  <intervention>
    <intervention_type>Drug</intervention_type>
    <intervention_name>Bupivacaine</intervention_name>
    <description>7.5 mg hyperbaric bupivacaine 0.5% and 25 mcg fentanyl for spinal anesthesia</description>
    <arm_group_label>Bupivacaine 7.5 mg</arm_group_label>
    <other_name>7.5 mg hyperbaric bupivacaine 0.5%</other_name>
  </intervention>
  <eligibility>
    <criteria>
      <textblock>
        Inclusion Criteria:&#xD;
&#xD;
          -  pregnant women with ASA PS 1-3&#xD;
&#xD;
          -  age 18-40 years old&#xD;
&#xD;
          -  in an elective or emergency cesarean delivery using spinal anesthesia&#xD;
&#xD;
        Exclusion Criteria:&#xD;
&#xD;
          -  patients with contraindication of spinal anesthesia&#xD;
&#xD;
          -  have history of allergy to bupivacaine or fentanyl&#xD;
&#xD;
          -  with eclampsia&#xD;
&#xD;
          -  valvular heart disease&#xD;
&#xD;
          -  congenital heart disease&#xD;
&#xD;
          -  coronary heart disease&#xD;
&#xD;
          -  twin pregnancy&#xD;
&#xD;
          -  morbid obesity (BMI &gt;=40)&#xD;
&#xD;
          -  pre-partum hemorrhage with hemodynamic instability&#xD;
      </textblock>
    </criteria>
    <gender>Female</gender>
    <gender_based>Yes</gender_based>
    <gender_description>Pregnant women</gender_description>
    <minimum_age>18 Years</minimum_age>
    <maximum_age>40 Years</maximum_age>
    <healthy_volunteers>Accepts Healthy Volunteers</healthy_volunteers>
  </eligibility>
  <location>
    <facility>
      <name>Cipto Mangunkusumo Hospital</name>
      <address>
        <city>Jakarta Pusat</city>
        <state>DKI Jakarta</state>
        <zip>10430</zip>
        <country>Indonesia</country>
      </address>
    </facility>
  </location>
  <location_countries>
    <country>Indonesia</country>
  </location_countries>
  <reference>
    <citation>Arzola C, Wieczorek PM. Efficacy of low-dose bupivacaine in spinal anaesthesia for Caesarean delivery: systematic review and meta-analysis. Br J Anaesth. 2011 Sep;107(3):308-18. doi: 10.1093/bja/aer200. Epub 2011 Jul 14.</citation>
    <PMID>21764820</PMID>
  </reference>
  <reference>
    <citation>Rollins M, Lucero J. Overview of anesthetic considerations for Cesarean delivery. Br Med Bull. 2012;101:105-25. doi: 10.1093/bmb/ldr050. Epub 2012 Jan 4.</citation>
    <PMID>22219238</PMID>
  </reference>
  <reference>
    <citation>Lee A, Ngan Kee WD, Gin T. Prophylactic ephedrine prevents hypotension during spinal anesthesia for Cesarean delivery but does not improve neonatal outcome: a quantitative systematic review. Can J Anaesth. 2002 Jun-Jul;49(6):588-99. doi: 10.1007/BF03017387.</citation>
    <PMID>12067872</PMID>
  </reference>
  <reference>
    <citation>Banerjee A, Stocche RM, Angle P, Halpern SH. Preload or coload for spinal anesthesia for elective Cesarean delivery: a meta-analysis. Can J Anaesth. 2010 Jan;57(1):24-31. doi: 10.1007/s12630-009-9206-7. Epub 2009 Oct 27.</citation>
    <PMID>19859776</PMID>
  </reference>
  <reference>
    <citation>Practice Guidelines for Obstetric Anesthesia: An Updated Report by the American Society of Anesthesiologists Task Force on Obstetric Anesthesia and the Society for Obstetric Anesthesia and Perinatology. Anesthesiology. 2016 Feb;124(2):270-300. doi: 10.1097/ALN.0000000000000935. No abstract available.</citation>
    <PMID>26580836</PMID>
  </reference>
  <reference>
    <citation>Qiu MT, Lin FQ, Fu SK, Zhang HB, Li HH, Zhang LM, Li Q. Combination of low-dose bupivacaine and opioids provides satisfactory analgesia with less intraoperative hypotension for spinal anesthesia in cesarean section. CNS Neurosci Ther. 2012 May;18(5):426-32. doi: 10.1111/j.1755-5949.2012.00306.x.</citation>
    <PMID>22533726</PMID>
  </reference>
  <reference>
    <citation>Ituk U, Habib AS. Enhanced recovery after cesarean delivery. F1000Res. 2018 Apr 27;7:F1000 Faculty Rev-513. doi: 10.12688/f1000research.13895.1. eCollection 2018.</citation>
    <PMID>29770203</PMID>
  </reference>
  <reference>
    <citation>Corso E, Hind D, Beever D, Fuller G, Wilson MJ, Wrench IJ, Chambers D. Enhanced recovery after elective caesarean: a rapid review of clinical protocols, and an umbrella review of systematic reviews. BMC Pregnancy Childbirth. 2017 Mar 20;17(1):91. doi: 10.1186/s12884-017-1265-0.</citation>
    <PMID>28320342</PMID>
  </reference>
  <reference>
    <citation>Leo S, Sng BL, Lim Y, Sia AT. A randomized comparison of low doses of hyperbaric bupivacaine in combined spinal-epidural anesthesia for cesarean delivery. Anesth Analg. 2009 Nov;109(5):1600-5. doi: 10.1213/ANE.0b013e3181b72d35.</citation>
    <PMID>19843797</PMID>
  </reference>
  <reference>
    <citation>Ben-David B, Miller G, Gavriel R, Gurevitch A. Low-dose bupivacaine-fentanyl spinal anesthesia for cesarean delivery. Reg Anesth Pain Med. 2000 May-Jun;25(3):235-9.</citation>
    <PMID>10834776</PMID>
  </reference>
  <reference>
    <citation>Ota E, Haruna M, Suzuki M, Anh DD, Tho le H, Tam NT, Thiem VD, Anh NT, Isozaki M, Shibuya K, Ariyoshi K, Murashima S, Moriuchi H, Yanai H. Maternal body mass index and gestational weight gain and their association with perinatal outcomes in Viet Nam. Bull World Health Organ. 2011 Feb 1;89(2):127-36. doi: 10.2471/BLT.10.077982. Epub 2010 Nov 10.</citation>
    <PMID>21346924</PMID>
  </reference>
  <verification_date>February 2019</verification_date>
  <study_first_submitted>February 1, 2019</study_first_submitted>
  <study_first_submitted_qc>February 5, 2019</study_first_submitted_qc>
  <study_first_posted type="Actual">February 8, 2019</study_first_posted>
  <last_update_submitted>February 7, 2019</last_update_submitted>
  <last_update_submitted_qc>February 7, 2019</last_update_submitted_qc>
  <last_update_posted type="Actual">February 11, 2019</last_update_posted>
  <responsible_party>
    <responsible_party_type>Principal Investigator</responsible_party_type>
    <investigator_affiliation>Indonesia University</investigator_affiliation>
    <investigator_full_name>Susilo Chandra</investigator_full_name>
    <investigator_title>Principal Investigator</investigator_title>
  </responsible_party>
  <keyword>pregnancy</keyword>
  <keyword>caesarean section</keyword>
  <keyword>spinal anesthesia</keyword>
  <keyword>bupivacaine</keyword>
  <keyword>opioid</keyword>
  <keyword>hypotension</keyword>
  <keyword>intraoperative</keyword>
  <keyword>postoperative</keyword>
  <condition_browse>
    <!-- CAUTION:  The following MeSH terms are assigned with an imperfect algorithm            -->
    <mesh_term>Hypotension</mesh_term>
    <mesh_term>Postoperative Complications</mesh_term>
  </condition_browse>
  <intervention_browse>
    <!-- CAUTION:  The following MeSH terms are assigned with an imperfect algorithm            -->
    <mesh_term>Bupivacaine</mesh_term>
  </intervention_browse>
  <patient_data>
    <sharing_ipd>Undecided</sharing_ipd>
  </patient_data>
  <!-- Results have not yet been posted for this study                                          -->
</clinical_study>


download date: ClinicalTrials.gov processed this data on September 20, 2023
link text: Link to the current ClinicalTrials.gov record.
url: https://clinicaltrials.gov/ct2/show/NCT03834454
org study id: IndonesiaUAnes027
nct id: NCT03834454
lead sponsor: 
has dmc: Yes
is fda regulated drug: No
is fda regulated device: No
This study aims to evaluate the efficacy of hyperbaric 5 mg bupivacaine + fentanyl 25 mcg
      versus hyperbaric 7.5 mg bupivacaine + fentanyl 25 mcg to lower incidence of hypotension
Approval from Ethical Committee of Faculty of Medicine Universitas Indonesia was acquired
      prior conducting the study. Subjects will be recruited using consecutive sampling method.
      Sample size was determined using alpha 5%, power 80%, and the difference of the incidence of
      hypotension 20%. The sample of each group is 56 patients. The investigators will use ECG,
      blood pressure monitoring, and pulse oxymetry for the standard monitoring. Patients will be
      given oxygen 3 L/minute via nasal cannula. Before the spinal anesthesia, patients will be
      given co-loading 500 ml of Ringer Lactate. Patients will be in sitting position while the
      lumbal puncture is conducted using 27G Quincke in the level of L3-4 or L4-5 or Tuffier's
      line. After ensuring that the tip of the needle is in the subarachnoid space, the drug will
      be administered with the speed of 0.2 mL/s. All the procedure will be conducted in sterile
      condition. Patients will receive ketoprofen suppositoria as the postoperative analgesia and
      can be discharged to the ward when the Aldrete's score is more than 8.

      The onset of sensoric blockade is assessed using pinprick test until the level of T6 or
      maximum until 20 minute. The peak value will be recorded. The motor blockade will be assessed
      using the Bromage scale. Incision will be done when the level of sensory block reached T6. If
      patients report pain after delivery of the baby, intravenous fentanyl 0,67-1 mcg/kg will be
      given twice with the interval of 10 minutes. If pain persists, conversion to general
      anesthesia will be conducted.

      The measurement of blood pressure, heart rate, respiratory rate, temperature, and O2
      saturation will be recorded during the minute of 3, 6, 9, 12, 15, 20, 30, 40, 50, and 60
      after the spinal anesthesia is administered or until the baby is delivered. Patients will be
      recorded as hypotensive when she experienced reduction of blood pressure more than 30% from
      baseline or systolic pressure less than 100 mmHg from the moment the spinal anesthesia is
      administered until the baby is delivered. If the systolic pressure is less than 90 mmHg,
      patient will be given ephedrine 5 mg iv that is repeated every minute until the systolic
      pressure is over 90 mmHg.

      The duration of the surgery is also recorded. Nausea, vomiting, syncope, dizziness, chest
      discomfort, and other intraoperative complaint will be recorded. Postoperative nausea and
      vomiting, itching, shivering, back pain, Post Dural Puncture Headache (PDPH), and Transient
      Neurologic Symptoms (TNS) will also be recorded.
allocation: Randomized
intervention model: Parallel Assignment
primary purpose: Supportive Care
masking: Double (Participant, Investigator)
masking description: Simple randomization will be conducted using a software by one of the researchers (HA) into two groups with equal size. To ensure the concealment, the randomization list will be kept in a sealed enveloped and opened by the physician who administered the spinal anesthesia just before the surgery. Data recording will be conducted by independent observers. This is a double-blinded study for the subjects and for the observers. The enrollment of the participants will be conducted by HA. Patients will not be notified about the dose scheme. Physician who performed the spinal anesthesia are different from the observers. Observers are junior residents trained to test the spinal adequacy and to perform monitoring in spinal anesthesia. It us not possible to blind the physicians who perform the spinal anesthesia because they will notice the volume difference.
measure: Incidence of hypotension
time frame: 60 minutes
description: recorded during the minute of 3, 6, 9, 12, 15, 20, 30, 40, 50, and 60 after the spinal anesthesia will be administered or until the baby is delivered
measure: Adequacy of Anesthesia
time frame: 120 minutes
description: Requirement of additional local anesthetics
measure: Quality of anesthesia: as reported by patients and surgeons
time frame: 120 minutes
description: Quality of anesthesia as reported by patients and surgeons
measure: Motor recovery
time frame: 10 hours
description: Duration of motor recovery after surgery
arm group label: Bupivacaine 5 mg
arm group type: Active Comparator
description: 5 mg hyperbaric bupivacaine 0.5% and 25 mcg fentanyl for spinal anesthesia
arm group label: Bupivacaine 7.5 mg
arm group type: Active Comparator
description: 7.5 mg hyperbaric bupivacaine 0.5% and 25 mcg fentanyl for spinal anesthesia
intervention type: Drug
intervention name: Bupivacaine
description: 5 mg hyperbaric bupivacaine 0.5% and 25 mcg fentanyl for spinal anesthesia
arm group label: Bupivacaine 5 mg
other name: 5 mg hyperbaric bupivacaine 0.5%
intervention type: Drug
intervention name: Bupivacaine
description: 7.5 mg hyperbaric bupivacaine 0.5% and 25 mcg fentanyl for spinal anesthesia
arm group label: Bupivacaine 7.5 mg
other name: 7.5 mg hyperbaric bupivacaine 0.5%
criteria: 
gender: Female
gender based: Yes
gender description: Pregnant women
minimum age: 18 Years
maximum age: 40 Years
healthy volunteers: Accepts Healthy Volunteers
facility: 
country: Indonesia
citation: Arzola C, Wieczorek PM. Efficacy of low-dose bupivacaine in spinal anaesthesia for Caesarean delivery: systematic review and meta-analysis. Br J Anaesth. 2011 Sep;107(3):308-18. doi: 10.1093/bja/aer200. Epub 2011 Jul 14.
PMID: 21764820
citation: Rollins M, Lucero J. Overview of anesthetic considerations for Cesarean delivery. Br Med Bull. 2012;101:105-25. doi: 10.1093/bmb/ldr050. Epub 2012 Jan 4.
PMID: 22219238
citation: Lee A, Ngan Kee WD, Gin T. Prophylactic ephedrine prevents hypotension during spinal anesthesia for Cesarean delivery but does not improve neonatal outcome: a quantitative systematic review. Can J Anaesth. 2002 Jun-Jul;49(6):588-99. doi: 10.1007/BF03017387.
PMID: 12067872
citation: Banerjee A, Stocche RM, Angle P, Halpern SH. Preload or coload for spinal anesthesia for elective Cesarean delivery: a meta-analysis. Can J Anaesth. 2010 Jan;57(1):24-31. doi: 10.1007/s12630-009-9206-7. Epub 2009 Oct 27.
PMID: 19859776
citation: Practice Guidelines for Obstetric Anesthesia: An Updated Report by the American Society of Anesthesiologists Task Force on Obstetric Anesthesia and the Society for Obstetric Anesthesia and Perinatology. Anesthesiology. 2016 Feb;124(2):270-300. doi: 10.1097/ALN.0000000000000935. No abstract available.
PMID: 26580836
citation: Qiu MT, Lin FQ, Fu SK, Zhang HB, Li HH, Zhang LM, Li Q. Combination of low-dose bupivacaine and opioids provides satisfactory analgesia with less intraoperative hypotension for spinal anesthesia in cesarean section. CNS Neurosci Ther. 2012 May;18(5):426-32. doi: 10.1111/j.1755-5949.2012.00306.x.
PMID: 22533726
citation: Ituk U, Habib AS. Enhanced recovery after cesarean delivery. F1000Res. 2018 Apr 27;7:F1000 Faculty Rev-513. doi: 10.12688/f1000research.13895.1. eCollection 2018.
PMID: 29770203
citation: Corso E, Hind D, Beever D, Fuller G, Wilson MJ, Wrench IJ, Chambers D. Enhanced recovery after elective caesarean: a rapid review of clinical protocols, and an umbrella review of systematic reviews. BMC Pregnancy Childbirth. 2017 Mar 20;17(1):91. doi: 10.1186/s12884-017-1265-0.
PMID: 28320342
citation: Leo S, Sng BL, Lim Y, Sia AT. A randomized comparison of low doses of hyperbaric bupivacaine in combined spinal-epidural anesthesia for cesarean delivery. Anesth Analg. 2009 Nov;109(5):1600-5. doi: 10.1213/ANE.0b013e3181b72d35.
PMID: 19843797
citation: Ben-David B, Miller G, Gavriel R, Gurevitch A. Low-dose bupivacaine-fentanyl spinal anesthesia for cesarean delivery. Reg Anesth Pain Med. 2000 May-Jun;25(3):235-9.
PMID: 10834776
citation: Ota E, Haruna M, Suzuki M, Anh DD, Tho le H, Tam NT, Thiem VD, Anh NT, Isozaki M, Shibuya K, Ariyoshi K, Murashima S, Moriuchi H, Yanai H. Maternal body mass index and gestational weight gain and their association with perinatal outcomes in Viet Nam. Bull World Health Organ. 2011 Feb 1;89(2):127-36. doi: 10.2471/BLT.10.077982. Epub 2010 Nov 10.
PMID: 21346924
responsible party type: Principal Investigator
investigator affiliation: Indonesia University
investigator full name: Susilo Chandra
investigator title: Principal Investigator
mesh term: Hypotension
mesh term: Postoperative Complications
mesh term: Bupivacaine
sharing ipd: Undecided