scholarly journals Anatomical predicting factors of difficult spinal anesthesia in patients undergoing cesarean section: An observational study

2019 ◽  
Vol 35 (6) ◽  
Author(s):  
Simin Atashkhoei ◽  
Saeed Samudi ◽  
Naghi Abedini ◽  
Nahid Khoshmaram ◽  
Masoumeh Minayi
Keyword(s):  
Body Mass Index ◽  
Observational Study ◽  
Cesarean Section ◽  
Spinal Anesthesia ◽  
Body Mass ◽  
Spinous Process ◽  
Spinal Column ◽  
Elective Cesarean Section ◽  
Predicting Factors ◽  
Body Appearance

Objectives: Although Spinal anesthesia is the most common and safe anesthetic method for patients undergoing cesarean section, difficult access to it is a frequent problem in operating theaters. The predictive factors for the difficulty of spinal anesthesia in patients undergoing cesarean section were investigated. Methods: A total of 110 pregnant women, single-stranded, aged 18-40 years old and ASA class I or II candidates for elective cesarean section with spinal anesthesia were studied. Demographic information, body appearance, ability to bend the back of the patient was recoded. Also the position of the anatomical landmarks of the lumbar spine, the presence or absence of deformity in the spinal column lumbar was recorded for all patients.  Results: The correlation coefficient of age, weight, body mass index, general body appearance, retention ability, anatomical signs of the spinal column (touching the spinous process) and the interval between the vertebra with the difficulty of spinal anesthesia were statistically significant (p<0.05). Complications after spinal anesthesia had a statistically significant relationship with the difficulty of performing spinal blockade (p: 0.006). Conclusion: Increasing age, weight, body mass index, reducing the ability to bend the waist, the non-touching of the spinous process and interstitial space causes the difficulty of performing spinal anesthesia in patients undergoing cesarean section. The results can contribute to determining and designing a spinal blockade scoring system based on the patient’s characteristics and effective factors before the surgery, to facilitate the technique by anesthesiologist.  doi: https://doi.org/10.12669/pjms.35.6.1276 How to cite this:Atashkhoei S, Samudi S, Abedini N, Khoshmaram N, Minayi M. Anatomical predicting factors of difficult spinal anesthesia in patients undergoing cesarean section: An observational study. Pak J Med Sci. 2019;35(6):1707-1711.   doi: https://doi.org/10.12669/pjms.35.6.1276 This is an Open Access article distributed under the terms of the Creative Commons Attribution License (http://creativecommons.org/licenses/by/3.0), which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.

scholarly journals The relation between body mass index and difficulty in inducing spinal anesthesia in elective cesarean section

2021 ◽  
Vol 37 (1) ◽  
pp. 373-376
Author(s):  
Reham Mahrous ◽  
Mahmoud Alalfy ◽  
Shaimaa Abdalaleem Abdalgeleel ◽  
Amr Abdelnasser ◽  
Doaa A. Abd Elfattah ◽  
...  
Keyword(s):  
Body Mass Index ◽  
Cesarean Section ◽  
Spinal Anesthesia ◽  
Body Mass ◽  
Elective Cesarean Section ◽  
Elective Cesarean

Risk factors for hypotension in regional spinal anesthesia for cesarean section. Role of the Waist-to-Hip Ratio and Body Mass Index

2018 ◽  
Vol 46 (1) ◽  
pp. 42-48 ◽  
Author(s):  
María Gabriela López Hernández ◽  
Héctor Julio Meléndez Flórez ◽  
Saúl Álvarez Robles ◽  
Jorge de Lugan Alvarado Arteaga
Keyword(s):  
Risk Factors ◽  
Body Mass Index ◽  
Cesarean Section ◽  
Spinal Anesthesia ◽  
Body Mass ◽  
Waist To Hip Ratio

Comparison of the effects of Dexamethasone and Ondansetron on the Reduction of Postoperative Nausea and Vomiting following Cesarean Section under Spinal Anesthesia

2020 ◽  
Vol 15 ◽  
Author(s):  
Arash karimi ◽  
Jahanbakhsh Nejadi ◽  
Mahnaz Shamseh ◽  
Nooshin Ronasi ◽  
Mehdi Birjandi
Keyword(s):  
Cesarean Section ◽  
Spinal Anesthesia ◽  
Postoperative Nausea ◽  
Demographic Data ◽  
Postoperative Nausea And Vomiting ◽  
Nausea And Vomiting ◽  
Elective Cesarean Section ◽  
Double Blind ◽  
Group A ◽  
Group B

Background: Postoperative nausea and vomiting (PONV) is a common complication associated with the use of anesthesia. Several antiemetics are used to reduce the incidence and severity of PONV. The aim of this study is to investigate the role of dexamethasone and ondansetron to treat PONV in patients undergoing cesarean section (c-section) under spinal anesthesia. Methods: This double-blind clinical trial study was performed on patients who were referred to the operating room of Haji Karim Asali Hospital of Khorramabad for elective cesarean section in 2016-17. Upon meeting the inclusion criteria, patients were allotted into two groups (n=60). Group A received 8mg of dexamethasone and group B received 4mg of ondansetron after spinal anesthesia. The Visual Analog Scale (VAS) questionnaire and Depression-Anxiety-Stress Scale (DASS) questionnaire was used for the analysis. Patients with mild to moderate stress, anxiety, and depression were included in the study. Data were analyzed using SPSS 16 software. Results: There was no difference in the demographic data of the two groups. The mean severity of nausea in group A was significantly higher than in group B. The frequency of vomiting in group A was 20 times higher than group B, which was found to be statistically significant, p = 0.018. Concerning the type of delivery with the frequency of nausea, the results showed that the frequency of nausea in group A was 3.24 times higher than group B, however, this difference was not statistically significant, p = 0.106. Conclusion: Based on the results of this study, ondansetron had a significant effect on the alleviation of postoperative nausea and vomiting, as compared to dexamethasone in c-section surgical candidates.

scholarly journals Maternal body mass index and oxytocin in augmentation of labour in nulliparous women: a prospective observational study

BMJ Open ◽  
2021 ◽  
Vol 11 (3) ◽  
pp. e044754
Author(s):  
Anna Ramö Isgren ◽  
Preben Kjölhede ◽  
Sara Carlhäll ◽  
Marie Blomberg
Keyword(s):  
Body Mass Index ◽  
Observational Study ◽  
Body Mass ◽  
Infusion Rate ◽  
Maximum Rate ◽  
Prospective Observational Study ◽  
Normal Weight ◽  
Nulliparous Women ◽  
Oxytocin Infusion ◽  
Labour Ward

ObjectiveTo evaluate oxytocin use for augmentation of labour in relation to body mass index (BMI) on admission to the labour ward, focusing on cumulative oxytocin dose and maximum rate of oxytocin infusion during the first stage of labour.DesignProspective observational study.SettingSeven hospitals in Sweden.Participants1097 nulliparous women with singleton cephalic presentation pregnancy, ≥37 weeks of gestation, spontaneous onset of labour and treatment with oxytocin infusion for labour augmentation. The study population was classified into three BMI subgroups on admission to the labour ward: normal weight (18.5–24.9), overweight (25.0–29.9) and obese (≥30.0). The cumulative oxytocin dose was measured from the start of oxytocin infusion until the neonate was born.Primary outcomeCumulative oxytocin dose.Secondary outcomeMaximum rate of oxytocin infusion during the active phase of first stage of labour.ResultsThe mean cumulative oxytocin dose increased in the BMI groups (normal weight 2278 mU, overweight 3108 mU and obese 4082 mU (p<0.0001)). However, when adjusted for the confounders (cervical dilatation when oxytocin infusion was started, fetal birth weight, epidural analgesia), the significant difference was no longer seen. The maximum oxytocin infusion rate during the first stage of labour differed significantly in the BMI groups when adjusted for the confounding factors individually but not when adjusted for all three factors simultaneously. In addition, the maximum oxytocin infusion rate was significantly higher in women with emergency caesarean section compared with women with vaginal delivery.ConclusionsWomen with increasing BMI with augmentation of labour received a higher cumulative oxytocin dose and had a higher maximum oxytocin infusion rate during first stage of labour, however, when adjusted for relevant confounders, the difference was no longer seen. In the future, the guidelines for augmentation of labour with oxytocin infusion might be reconsidered and include modifications related to BMI.

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