scholarly journals Preoperative anxiety can cause convulsion and severe hypotension immediately after spinal anaesthesia for caesarean delivery: a case report

2019 ◽  
Vol 47 (10) ◽  
pp. 5323-5327 ◽  
Author(s):  
Eun-jin Moon ◽  
Yoonju Go ◽  
Gil Woo ◽  
Hyungseok Seo ◽  
Bong-Jae Lee
Keyword(s):  
Blood Pressure ◽  
Case Report ◽  
Early Detection ◽  
Spinal Anaesthesia ◽  
Regional Anaesthesia ◽  
Caesarean Delivery ◽  
Preoperative Anxiety ◽  
Severe Hypotension

Preoperative anxiety in patients under spinal anaesthesia may cause serious complications. We report a case of combined transient convulsion and severe hypotension immediately after spinal anaesthesia for caesarean delivery in a patient who presented with severe preoperative anxiety. Our patient’s consciousness and blood pressure recovered normally without any sequelae. However, preoperative anxiety can induce such complications, particularly in patients under regional anaesthesia. Therefore, early detection and deliberate management for preoperative anxiety are required for the patient’s safety and satisfaction.

scholarly journals Asymptomatic mediastinal extra-adrenal paraganglioma as a cause of sudden death: a case Report

2019 ◽  
Vol 14 (1) ◽  
pp. 564-567
Author(s):  
Qiancheng Xu ◽  
Yingya Cao ◽  
Hongzhen Yin ◽  
Rongrong Wu ◽  
Tao Yu ◽  
...  
Keyword(s):  
Blood Pressure ◽  
Case Report ◽  
Respiratory Failure ◽  
Pressure Drop ◽  
Thoracic Cavity ◽  
Severe Hypotension ◽  
Life Threatening ◽  
History Of ◽  
Posterior Mediastinal ◽  
Extra Adrenal Paraganglioma

AbstractA 23-year-old female patient was referred for treatment of a posterior mediastinal tumour. There was no history of hypertension or headache and no other complaints. The patient’s blood pressure increased to 210/125 mmHg after surgically manipulating the tumour, subsequently reversing to severe hypotension (25/15 mmHg) immediately after the tumour was removed. The life-threatening and irreversible blood pressure drop was difficult to treat with fluid and vasopressors, and the patient ultimately died of cardio-respiratory failure. Asymptomatic paraganglioma can be non-functional but can also be fatal. For any lump in the thoracic cavity, paraganglioma should be ruled out.

scholarly journals Corrected Scoliosis, Cholinesterase Deficiency, and Cesarean Section: A Case Report

2009 ◽  
Vol 2009 ◽  
pp. 1-3 ◽  
Author(s):  
Roy Somers ◽  
Yves Jacquemyn ◽  
Luc Sermeus ◽  
Marcel Vercauteren
Keyword(s):  
Case Report ◽  
Caesarean Section ◽  
Cesarean Section ◽  
General Anaesthesia ◽  
Spinal Anaesthesia ◽  
Regional Anaesthesia ◽  
Previous Caesarean Section ◽  
Corrective Surgery ◽  
Ultrasound Guided ◽  
Severe Scoliosis

We describe a patient with severe scoliosis for which corrective surgery was performed at the age of 12. During a previous caesarean section under general anaesthesia pseudocholinesterase deficiency was discovered. Ultrasound guided spinal anaesthesia was performed enabling a second caesarean section under loco-regional anaesthesia.

USG SAVED THE DAY: PRE-PROCEDURAL USG SPINE FOR SPINAL ANAESTHESIA IN A PARTURIENT WITH THORACO-LUMBAR SCOLIOSIS WITH POST BURN CONTRACTURE NECK

2021 ◽  
pp. 83-84
Author(s):  
Deepak Bhardwaj ◽  
Vishal Vashist ◽  
Bhanu Gupta
Keyword(s):  
Case Report ◽  
Spinal Anaesthesia ◽  
Regional Anaesthesia ◽  
Successful Outcome ◽  
Insertion Depth ◽  
Emergency Cesarean ◽  
Needle Trajectory ◽  
Intrathecal Space ◽  
Burn Contractures ◽  
Grade Iii

Introduction: Incidence of Scoliosis is approximately 2% and higher in females. Therefore, anaesthesiologist should be familiar with its implications for safe anaesthetic management1. Such parturients present unique challenges for administration of regional anaesthesia. Reporting one such case with a successful outcome using pre procedural Ultrasound spine for spinal anaesthesia. A 27 years, 39 weeks Case Report: primigravida of height 132 cm, with cephalo pelvic disproportion in labour with grade III scoliosis and post burn contractures involving neck, was posted for emergency cesarean section. Patient underwent surgery successfully under SAB after accessing spine by ultrasonography for identifying point of insertion, depth of intrathecal space & needle trajectory.2 Ultrasound is Conclusion: boon for accessing spine in patient with difcult spinal anatomy and pregnancy for deciding correct spinal interspace and successful outcome with fewer attempts.

scholarly journals Influence of preoperative anxiety on hypotension after spinal anaesthesia in women undergoing Caesarean delivery

2012 ◽  
Vol 109 (6) ◽  
pp. 943-949 ◽  
Author(s):  
S. Orbach-Zinger ◽  
Y. Ginosar ◽  
J. Elliston ◽  
C. Fadon ◽  
M. Abu-Lil ◽  
...  
Keyword(s):  
Spinal Anaesthesia ◽  
Caesarean Delivery ◽  
Preoperative Anxiety

scholarly journals Accuracy and trending abilities of finger plethysmographic blood pressure and cardiac output compared with invasive measurements during caesarean delivery in healthy women. An observational study.

2020 ◽  
Author(s):  
Ivar Nagelgaard Omenås ◽  
Christian Tronstad ◽  
Leiv Arne Rosseland
Keyword(s):  
Blood Pressure ◽  
Cardiac Output ◽  
Caesarean Section ◽  
Spinal Anaesthesia ◽  
Caesarean Delivery ◽  
Limits Of Agreement ◽  
Polar Plot ◽  
Non Invasive ◽  
Healthy Women ◽  
Cardiac Output Measurements

Abstract Background: In women presenting for caesarean section under spinal anaesthesia, continuous measurement of circulatory aspects, such as blood pressure and cardiac output, is often needed. At present, invasive techniques are used almost exclusively. Reliable non-invasive monitors would be welcome, as they could be safer and less uncomfortable, while easy and quick to apply. We aimed to evaluate whether a non-invasive, finger plethysmographic device, the ccNexFin monitor, can replace invasively measured blood pressure in the radial artery, and whether cardiac output measurements from this device can be used interchangeably with measurements from the mini-invasive LiDCO monitor, currently in use at our institution. Methods: Simultaneous invasive measurements were compared with ccNexFin in 23 healthy women during elective caesarean section under spinal anaesthesia. We used Bland Altman statistics for assessing agreement, and polar plot methodology for judging trending abilities with pre-defined limits. Results: Mean arterial and systolic pressures showed biases (invasive – ccNexFin) of -4.3 and 12.2 mmHg, with limits of agreement of -15.9 – 7.4 and -11.1 – 35.6, respectively. The ccNexFin trending abilities were within suggested limits for mean pressure, but insufficient for systolic pressure compared with invasive measurements. Cardiac output had a small bias of 0.2 L/min, but wide limits of agreement of -2.6 – 3.0. The ccNexFin trending abilities compared with the invasive estimated values (LiDCO) were unsatisfactory. Conclusions: We consider the ccNexFin monitor to have sufficient accuracy in measuring mean arterial pressures. The limits of agreement for systolic measurements were wider, and the trending ability, compared with invasive measurements, was outside the recommended limit. The ccNexFin is not reliable for cardiac output measurements or trend in pregnant women for caesarean delivery under spinal anaesthesia.

scholarly journals Norepinephrine versus phenylephrine for maintenance of blood pressure during spinal anaesthesia for caesarean delivery - A randomized double blind controlled study

2021 ◽  
Vol 8 (3) ◽  
pp. 460-464
Author(s):  
Devyani Desai ◽  
Bhoomika Kalarthi
Keyword(s):  
Blood Pressure ◽  
Heart Rate ◽  
Cardiac Output ◽  
Systolic Blood Pressure ◽  
Spinal Anesthesia ◽  
Spinal Anaesthesia ◽  
Caesarean Delivery ◽  
Controlled Study ◽  
Double Blind ◽  
Significant Difference

: Currently phenylephrine is a preferred 1 line vasopressor for maintenance of blood pressure during spinal anaesthesia, may be associated with reflex bradycardia and decreased cardiac output, posing risk to mother or foetus. Norepinephrine may be an useful alternative as being potent alpha with weak beta adrenergic agonist activity. : This study compared the effectiveness of prophylactic and treatment boluses of norepinephrine and phenylephrine to maintain systolic blood pressure at or above 80% of baseline value during spinal anesthesia for cesarean delivery with the primary aim to compare cardiac output. Secondary aims were total doses of study drug required, neonatal outcome and perioperative complications.: Total 100, term pregnant women with ASA status II undergoing caesarean delivery under spinal anaesthesia were enrolled in this prospective, double blind controlled study. Patients were randomized to receive prophylactic bolus dose of norepinephrine (6 µg) or phenylephrine (100 µg) immediately after spinal anaesthesia. Systolic blood pressure, cardiac output and heart rate were monitored. Intermittent bolus doses were repeated whenever required. Student ‘t’ test and chi square test were used for analysing the data. : Both the drugs were able to maintain the systolic blood pressure ≥ 80% of baseline (p=0.356). Significant difference observed in cardiac output while comparing both the groups from 3 to 15 minutes after spinal anesthesia (p=0.014). The incidence of bradycardia was lower in norepinephrine group as compared to phenylephrine group (P=0.018). : Norepinephrine is as effective as phenylephrine for maintenance of blood pressure after spinal anaesthesia for caesarean delivery with stable heart rate and cardiac output.

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.

Sudden bilateral hearing loss after spinal anaesthesia

2015 ◽  
Vol 129 (4) ◽  
pp. 395-397 ◽  
Author(s):  
C Sahin ◽  
U Terzioglu ◽  
G Yigit
Keyword(s):  
Hearing Loss ◽  
Case Report ◽  
Early Diagnosis ◽  
Literature Review ◽  
Hallux Valgus ◽  
Spinal Anaesthesia ◽  
Regional Anaesthesia ◽  
Orthopaedic Surgery ◽  
Bilateral Hearing Loss

AbstractBackground:Spinal anaesthesia is one of the most widely used regional anaesthesia techniques. Sudden bilateral hearing loss following spinal anaesthesia has only been reported in a few cases.Case report:This paper reports the case of a 50-year-old woman who developed sudden bilateral hearing loss following spinal anaesthesia for hallux valgus orthopaedic surgery. This is followed by a literature review.Results:The patient's hearing improved almost completely on the morning of the 3rd day following surgery. No recurrence of hearing loss, tinnitus or vertigo was reported during the six-month follow-up period.Conclusion:Some complications regarding hearing may emerge after spinal anaesthesia. The possibility of hearing loss after spinal anaesthesia should be taken into consideration. Complaints such as hearing loss, tinnitus or vertigo should be taken seriously when reported, and the patient should be referred to an ENT clinic. This will ensure early diagnosis and treatment.

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