Restrictive vs Liberal Intraoperative Fluid Strategy and Postoperative Outcomes After Elective Cesarean Section

Spinal anesthesia for elective cesarean section is frequently associated with hemodynamic instability and postoperative complications such as postoperative nausea and vomiting (PONV) and delayed gastrointestinal recovery. Although intraoperative fluid administration is routinely used to prevent spinal-induced hypotension, the optimal fluid strategy remains unclear. Both restrictive and liberal fluid approaches may influence maternal hemodynamics and postoperative outcomes through different physiological mechanisms. This prospective, single-center, randomized controlled trial aims to compare restrictive (≤3 mL/kg/h) and liberal (\>3 mL/kg/h) intraoperative crystalloid fluid strategies in patients undergoing elective cesarean section under spinal anesthesia. The primary outcome is the incidence of PONV within the first 24 hours postoperatively. Secondary outcomes include postdural puncture headache (PDPH), time to first flatus, hypotension frequency, and vasopressor requirements.

NCT Number	NCT07440667
Lead Sponsor	Nigde Omer Halisdemir University
Conditions	Cesarean Section, Postoperative Nausea and Vomiting (PONV), Postdural Puncture Headache (PDPH), Postoperative Ileus, Gastrointestinal Recovery
Enrollment	160 participants
Start Date	2026-03-04
Primary Completion	2027-01-30 (estimated)
Study Completion	2027-01-30 (estimated)
Updated on ClinicalTrials.gov	2026-03-10