Heart Rate Variability as a Predictor of Hypotension Following Spinal for Elective Caesarean Section

2018 ◽  
Vol 38 (1) ◽  
pp. 31-33
Author(s):  
D.G. Bishop ◽  
C. Cairns ◽  
M. Grobbelaar ◽  
R.N. Rodseth
Keyword(s):  
Heart Rate ◽  
Heart Rate Variability ◽  
Caesarean Section ◽  
Elective Caesarean Section

scholarly journals The effect of remifentanil used during caesarean section on maternal hemodynamics and neonatal outcome - comparison of two dosing regimens

2019 ◽  
Vol 147 (11-12) ◽  
pp. 699-705
Author(s):  
Marija Kutlesic ◽  
Svetlana Pavlovic ◽  
Ranko Kutlesic
Keyword(s):  
Heart Rate ◽  
Caesarean Section ◽  
Neonatal Outcome ◽  
Cardiovascular Response ◽  
Elective Caesarean Section ◽  
Hemodynamic Response ◽  
Skin Incision ◽  
Umbilical Blood ◽  
Dosing Regimens ◽  
Group A

Introduction/Objective. To present and compare maternal and neonatal effects of two remifentanil dosing regimens, used during induction-delivery period of elective caesarean section in attempt to attenuate maternal cardiovascular response to surgical stress. Methods. Seventy-seven ASA I-II parturients were randomly divided into three groups and received the following: A ? 1 ?g/kg remifentanil immediately before the induction to anesthesia followed by 0.15 ?g/ kg/min infusion, interrupted after skin incision; B ? 1 ?g/kg remifentanil bolus immediately before the induction; C ? no remifentanil until delivery. Hemodynamic (blood pressure, heart rate) and bispectral index changes after endotracheal intubation, skin incision, peritoneal incision and delivery, intraoperative anesthetics consumption and neonatal outcome have been compared between the groups. Results. Hemodynamic response to intubation was significantly attenuated (p < 0.001) in groups A and B compared to C. Hemodynamic response to skin incision, peritoneal incision and delivery was significantly attenuated in group A compared to B and C. Thiopentone dose in groups A and B was lower than in group C (p < 0.001); sevoflurane and remifentanil consumption was less in group A compared to B and C (p < 0.001). Apgar scores at 1st minute were ? 8 in all neonates, with no differences in neonatal heart rate, oxygen saturation and umbilical blood gas values (all within normal range). Conclusion. 1 ?g/kg remifentanil bolus followed by 0.15 ?g/kg/min stopped after skin incision, successfully blunted maternal hemodynamic stress response throughout whole induction-delivery period, reduced anesthetic consumption, without affecting neonatal outcome, so it can be considered effective as well as safe to use during induction-delivery period of caesarean section.

Heart rate variability changes during caesarean section under general or spinal anaesthesia

2004 ◽  
Vol 21 (Supplement 32) ◽  
pp. 157-158
Author(s):  
D. Dermitzaki ◽  
M. Neonaki ◽  
P. Georgogiannaki ◽  
E. Kallergis ◽  
H. Askitopoulou
Keyword(s):  
Heart Rate ◽  
Heart Rate Variability ◽  
Caesarean Section ◽  
Spinal Anaesthesia

scholarly journals Effect of weight gain during pregnancy on heart rate variability and hypotension during caesarean section under spinal anaesthesia

Anaesthesia ◽  
2011 ◽  
Vol 66 (12) ◽  
pp. 1106-1111 ◽  
Author(s):  
M. B. Ghabach ◽  
M. F. El-Khatib ◽  
T. G. Zreik ◽  
M. S. Matta ◽  
J. J. Mouawad ◽  
...  
Keyword(s):  
Heart Rate ◽  
Heart Rate Variability ◽  
Weight Gain ◽  
Caesarean Section ◽  
Spinal Anaesthesia ◽  
Weight Gain During Pregnancy

scholarly journals Blood pressure and cardiac output during caesarean delivery under spinal anaesthesia: a prospective cohort study

BMJ Open ◽  
2021 ◽  
Vol 11 (6) ◽  
pp. e046102
Author(s):  
Trond Melbye Michelsen ◽  
Christian Tronstad ◽  
Leiv Arne Rosseland
Keyword(s):  
Blood Pressure ◽  
Heart Rate ◽  
Cardiac Output ◽  
Cohort Study ◽  
Caesarean Section ◽  
Spinal Anaesthesia ◽  
Prospective Cohort ◽  
Caesarean Delivery ◽  
Elective Caesarean Section ◽  
Secondary Outcome

ObjectivesWe have previously established a method to measure transfer of nutrients between mother, placenta and fetus in vivo. The method includes measurements of maternal and fetal blood flow by Doppler ultrasound prior to spinal anaesthesia. Spinal anaesthesia affects maternal blood pressure and cardiac output. We aimed to determine the effect of spinal anaesthesia in mothers undergoing an elective caesarean section on blood pressure, heart rate and cardiac output, and whether cardiac output levels were comparable before induction of spinal anaesthesia and before delivery.DesignProspective cohort study.SettingTertiary hospital in Norway.Participants76 healthy women with uneventful pregnancies undergoing an elective caesarean section.InterventionsWe induced spinal anaesthesia with a standard prevention of hypotension including intravenous fluid coloading and phenylephrine infusion.Primary and secondary outcome measuresPrimary outcome measure was maternal cardiac output, and secondary outcome measures were invasive systolic blood pressure and heart rate. We measured heart rate and blood pressure by continuous invasive monitoring with a cannula in the radial artery. Cardiac output was estimated based on continuous arterial waveform. We compared maternal parameters 30 s before induction of spinal anaesthesia to 30 s before delivery.ResultsMedian age at delivery was 34.5 (range 21–43) years and 17 of 76 women were nulliparous. The most prevalent indications were previous caesarean section and maternal request. Among 76 included women, 71 had sufficient data for analysis of endpoints. Median cardiac output was 6.51 (IQR (5.56–7.54) L/min before spinal anaesthesia and 6.40 (5.83–7.56) L/min before delivery (p=0.40)). Median invasive systolic blood pressure increased from 128.5 (120.1–142.7) mm Hg to 134.1 (124.0–146.6) mm Hg (p=0.014), and mean heart rate decreased from 86.0 (SD 13.9) to 75.2 (14.2) (p<0.001).ConclusionsMaternal cardiac output at the time of caesarean delivery is comparable to levels before induction of spinal anaesthesia.Trial registration numberNCT00977769.

scholarly journals Comparison of Ondansetron And Ondansetron Plus Alprazolum for Prevention of Nausea and Vomiting Following Elective Caesarean Section

2009 ◽  
Vol 21 (1) ◽  
pp. 43-49
Author(s):  
Md Rafiqul Hasan Khan ◽  
SN Samad Choudhury
Keyword(s):  
Blood Pressure ◽  
Heart Rate ◽  
Caesarean Section ◽  
Postoperative Period ◽  
Postoperative Nausea ◽  
Elective Caesarean Section ◽  
Postoperative Nausea And Vomiting ◽  
Nausea And Vomiting ◽  
Group A ◽  
Group B

Pregnancy & operation both causes anxiety. Excessive anxiety & noncompliance with fasting can increase gastric volume & predispose patients to postoperative nausea & vomiting. Prevention rather than treatment of postoperative nausea and vomiting should be the anesthetist's aim. It was a prospective double blind comparative study of 60 parturient scheduled for elective caesarean section under subarachnoid block to see the effect of anxiolytic drug on per & PONV in LUCS. We have carried out comparative study with alprazolum as anxiolytic agent & compared the action of Ondansetron with Ondansetron +alprazolum. Parturient at term or elective caesarean section included in the study were ASA grade I & II. A total of 60 cards, 30 in each group were prepared by another person who was blind for the study. Every parturient was allowed to draw one card and grouped accordingly. Group A: Inj. Ondansetron (8mg), Group B: Oral alprazolum (0.25mg) +inj. ondansetron (8mg). After 20 minutes of prehydration under all aseptic precaution lumber puncture was performed with 25 gauge Quincke's needle in the L3-L4 or L4-L5 space in sitting position and 0.5% Hyperbaric Bupivacaine 2.5 ml (12.5 mg.) was injected within 10-12 sec. Immediately after administration of spinal anaesthesia fetal heart rate was noted for any changes in pulse rate, blood pressure, rate of respiration, discomfort and occurrence of side effects: shivering, nausea, vomiting was recorded every 2 minute for first 10 minutes, then at 10 minutes interval for remainder of the operation. Per operative monitoring such as ECG, continuous SpO2, non invasive arterial blood pressure was recorded each two minutes interval from time of intrathecal injection up to 10 minutes and then at 10 minutes interval until the end of operation. In the recovery room postoperative analgesia was provided with injection ketorolac tromethamine 30 mg IM on complaining pain and repeated in all patients if necessary. Presence of nausea and vomiting patients were interviewed at one hourly over the first 3 hours then at 3 hourly up to 24 hours postoperative period. Rescue antiemetic of prochlorparazine 10 mg I/M was given if vomiting occurs once, nausea for 10 minutes or at the patient request. Rest other parameters as for example; heart rate, BP, respiration and SpO2 were also recorded at same interval. Patients were carefully observed for any adverse effects like headache, flushing, drowsiness or any other symptoms. In the present study incidence of nausea and vomiting in group-A was one and in group-B was zero. Regarding hemodynamic changes (Pulse, Blood pressure) SpO2, respiratory changes, during operation and 24 hours post operative period in some occasions significant changes were observed (P<0.05) but in other occasions no significant changes occur. No other adverse effect like headache, constipation and flushing during operation and 24 hours postoperative period were observed in this study. In this study we have found that Ondansetron reduces peroperative and postoperative nausea and vomiting. But addition of Alprazolum (an anxiolytic) to Ondansetron, the chance of nausea and vomiting was less.   Journal of BSA, Vol. 21, No. 1, January 2008 43-49

scholarly journals Maternal hemodynamic effect of prophylactic glycopyrrolate after spinal anaesthesia for elective caesarean section

2021 ◽  
Vol 8 (1) ◽  
pp. 44-50
Author(s):  
Roshan Piya ◽  
Anil Shrestha ◽  
Manisha Pradhan ◽  
Shirish Amatya ◽  
Niroj Hirachan ◽  
...  
Keyword(s):  
Blood Pressure ◽  
Heart Rate ◽  
Mean Arterial Pressure ◽  
Caesarean Section ◽  
Arterial Pressure ◽  
Spinal Anesthesia ◽  
Elective Caesarean Section ◽  
Hemodynamic Effect ◽  
Group I ◽  
Group Ii

Introduction: Hypotension and bradycardia are the most common complications during spinal anesthesia. Bradycardia decreases cardiac output, resulting in hypotension and even cardiac arrest. Glycopyrronium, an anticholinergic drug increases heart rate and prevents bradycardia during spinal anesthesia by blocking the effects of acetylcholine on the sinoatrial node. The study aims to measure the maternal hemodynamic effect of glycopyrrolate after spinal anesthesia for elective caesarean section. Method: An intervention, comparative study was conducted in Patan Hospital after approval from Ethical Committee. Eighty-two pregnant women scheduled for elective caesarean section were randomly assigned in two groups by sealed envelope method; Group I received glycopyrrolate 0.2mg intravenous,  Group II did not receive glycopyrrolate. The patient’s heart rate, blood pressure, mean arterial pressure, a total dose of ephedrine, the occurrence of nausea, vomiting, and dry mouth were recorded. Independent-T test, chi-square test were used for statistical analysis. Result: Among 82 elective caesarean sections, 41 in each group, Group II (non-glycopyrrolate) reported increased heart rate compared to Group I (glycopyrrolate), but was statistically not significant. The highest recorded diastolic blood pressure was more in Group I compared to Group II and was statistically significant. The highest recorded Mean Arterial Pressure was high in the glycopyrrolate group and was statistically significant. The total dose of ephedrine was lower in the statistically significant glycopyrrolate group. The incidence of dry mouth was more in the glycopyrrolate group and the difference was statistically significant. Conclusion: Glycopyrrolate reduces the incidence of hypotension but not bradycardia and decreases the need for vasopressor.

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