scholarly journals Effect of Anesthesia Techniques on Pain Severity, Hemodynamic Changes, and Patients’ Satisfaction in Elective Cesarean Section

2020 ◽  
Author(s):  
Abdollah Jafarzadeh ◽  
Maryam Hadavi ◽  
Gholamhossein Hasanshahi ◽  
Mohsen Rezaeian ◽  
Reza Vazirinejad ◽  
...  
Keyword(s):  
Blood Pressure ◽  
Heart Rate ◽  
Postoperative Pain ◽  
Cesarean Section ◽  
Diastolic Blood Pressure ◽  
Elective Cesarean Section ◽  
Hemodynamic Changes ◽  
Apgar Scores ◽  
Patients Satisfaction ◽  
Elective Cesarean

The severity of postoperative pain and hemodynamic changes during and post-cesarean section have a direct effect on the neonatal and maternal condition. This study aimed to compare pain severity, hemodynamic changes, and patient satisfaction following two anesthesia techniques in elective cesarean section. In this blinded study, 60 women who were candidate for cesarean section were allocated into two equal groups of general anesthesia (GA) and spinal anesthesia (SA). Systolic blood pressure (SBP), diastolic blood pressure (DBP), heart rate (HR), and O2 Saturation at pre cesarean (T0), the uterine incision time (T1), end of surgery (T2), 6h (T3), 12h (T4), and 24 hours post-cesarean (T5) were measured. A Visual Analog Scale assessed post-cesarean pain, 6, 12, and 24 hours post-cesarean. Gender, birth weight, first- and fifth- minutes’ apgar score was recorded in the checklists. The VAS score was significantly higher in the GA group at 6h, 12h, and 24 hours post-cesarean (P=0.014, P=0.002, P=0.017, respectively). SBP and DBP at T1 in the GA group were significantly higher than in the S.A group (P<0.001). The heart rate at T0 and T1 in the GA group was lower than the SA group (P=0.001, P=0.045 respectively). The difference between the apgar scores of the two groups was not significant. SA for cesarean section was associated with lower postoperative pain, systolic and diastolic blood pressure. However, the two groups had no significant difference in terms of patients’ satisfaction and apgar scores. © 2019 Tehran University of Medical Sciences. All rights reserved. Acta Med Iran 2019;57(7):424-429.

scholarly journals Efficacy of Intravenous Ondansetron on Hemodynamic Complications in Women Undergoing Spinal Anesthesia for Cesarean Section: A Randomized Placebo Controlled Clinical Trial

2016 ◽  
Vol 5 (1) ◽  
pp. 13-18
Author(s):  
Pouran Hajian ◽  
Bita Malekianzadeh ◽  
Maryam Davoudi
Keyword(s):  
Blood Pressure ◽  
Heart Rate ◽  
Placebo Group ◽  
Cesarean Section ◽  
Spinal Anesthesia ◽  
Nausea And Vomiting ◽  
Elective Cesarean Section ◽  
Controlled Clinical Trial ◽  
Sterile Water ◽  
Elective Cesarean

Background: Several methods are used for the prevention or decreasing the incidence of spinal anesthesia hemodynamic complications. Ondansetron is a 5HT3 receptor antagonist with known efficacy on preventing nausea and vomiting and probably on intrathecal opioid-induced pruritus. The present study aims to evaluate the effects of intravenous Ondansetron on the attenuation of blood pressure and heart rate, by 5HT3 blocking in vagal nerve endings and effect on Bezold Jarish reflex. Material and Methods: One hundred and two candidates for elective cesarean section were randomized into 2 groups of 51 cases, the Ondansetron group received 4mg Ondansetron intravenously before performing spinal anesthesia, and placebo group received 2cc sterile water. Hypotension was defined: Systolic blood pressure less than 100 MmHg or fall more than 20% from primary BP which was treated by administration of Ephedrine in case of any. In both groups, Ondansetron effect was studied on hypotension occurrence, bradycardia, consumed Ephedrine amount, pruritus, nausea and vomiting. Results: There were no statistically significant differences in systolic/diastolic blood pressure, Mean Arterial Pressure, heart rate and pruritus in both groups (P=0.081).Nausea and vomiting in the first 10 minutes after spinal anesthesia were lesser in Ondansetron group (P= 0.001). Mean consumed Ephedrine was significantly lesser in Ondansetron group (5.8 mg in Ondansetron and 10.7 mg in placebo group, P=0.009). Conclusion: Ondansetron  given  intravenously  with  antiemetic  dose  (4  mg)  decreases  mean consumed Ephedrine and nausea and vomiting after spinal anesthesia, but does not have an influence on blood pressure, heart rate and pruritus.[GMJ. 2016;5(1):13-18]

scholarly journals Low Dose Hyperbaric Bupivacaine with Fentanyl in Spinal Anesthesia in Elective Cesarean Section

2019 ◽  
Vol 9 (2) ◽  
pp. 79-82
Author(s):  
Bharati Devi Sharma Regmi ◽  
Gopendra Prasad Deo ◽  
Subin Shrestha ◽  
Sabita Shrestha ◽  
Renuka Tamrakar Mishra
Keyword(s):  
Blood Pressure ◽  
Heart Rate ◽  
Cesarean Section ◽  
Spinal Anesthesia ◽  
Low Dose ◽  
Nausea And Vomiting ◽  
Elective Cesarean Section ◽  
Hyperbaric Bupivacaine ◽  
Significant Difference ◽  
Elective Cesarean

Background: Spinal anesthesia with hyperbaric bupivacaine provides a dense neural block in cesarean delivery but associated with side effects like hypotension, bradycardia nausea and vomiting. Addition of low dose fentanyl with low dose of hyperbaric bupivacaine may decrease the in­cidence of these complications. The aims of study was to compare the hemodynamic parameters (blood pressure and heart rate), nausea and vomiting with low dose intrathecal hyperbaric bupivacaine with fentanyl vs a conventional dose of intrathecal hyperbaric bupivacaine in patient undergoing elective cesarean section. Methods: Seventy-four pregnant women aged 20-35 years old which un­derwent elective cesarean section at Chitwan Medical College were ran­domized into two groups. One group received spinal anesthesia with 8mg of0.5% hyperbaric bupivacaine and 25μg fentanyl and another group re­ceived 12mg 0.5% bupivacaine. Results: The mean age, baseline heart rate, systolic and diastolic blood pressure were comparable in both groups. Significant difference in hypo­tension (24.31% vs. 62.16%, p<0.05) and Nausea and vomiting (16.20% vs. 27%, p<0.05) were found in bupivacaine-fentanyl group versus a conven­tional dose of spinal bupivacaine group. Conclusions: Low dose of bupivacaine with Fentanyl provides good spinal anesthesia for cesarean section with less hypotension, nausea and vomit­ing in comparison to bupivacaine alone.

scholarly journals Efficacy of Phenylephrine in Preventing Hemodynamic Responses of Oxytocin during Elective Cesarean Section: A Randomized, Double-Blind, Controlled Trial

2019 ◽  
Vol 55 (01) ◽  
pp. 048-053
Author(s):  
Medha Mohta ◽  
Vijay Kumar ◽  
Rachna Agarwal ◽  
Geetanjali T. Chilkoti ◽  
Sakshi Duggal
Keyword(s):  
Cesarean Section ◽  
Normal Saline ◽  
Controlled Trial ◽  
Saline Group ◽  
Elective Cesarean Section ◽  
Hemodynamic Changes ◽  
Singleton Pregnancy ◽  
Double Blind ◽  
Elective Cesarean ◽  
Better Than

AbstractThis study compared hemodynamic changes and occurrence of complications following oxytocin administration with a prior injection of phenylephrine 100 μg or normal saline during elective cesarean section. Sixty-six healthy term parturients with uncomplicated, singleton pregnancy undergoing elective cesarean section under spinal anesthesia were studied. They received either intravenous phenylephrine 100 μg or normal saline before oxytocin 3 IU was administered over 30 seconds. Oxytocin dose was repeated depending on the adequacy of uterine tone. There was no significant change in systolic, diastolic, and mean arterial pressures during the initial 3 minutes following oxytocin administration in the phenylephrine group but a significant fall in mean and diastolic pressures in the saline group. Heart rate did not change significantly, and no significant complications occurred in either of the groups. To conclude, phenylephrine 100 μg administered before oxytocin injection maintained hemodynamic parameters better than normal saline injection during elective cesarean section.

Fetal Heart Rate after Epidural Lidocaine and Bupivacaine for Elective Cesarean Section

1991 ◽  
Vol 75 (3) ◽  
pp. 406-412 ◽  
Author(s):  
John R. Loftus ◽  
R. Hal Holbrook ◽  
Sheila E. Cohen
Keyword(s):  
Heart Rate ◽  
Cesarean Section ◽  
Fetal Heart Rate ◽  
Fetal Heart ◽  
Elective Cesarean Section ◽  
Elective Cesarean

Epidural Mepivacaine for Cesarean Section: Maternal and Neonatal Effects

1987 ◽  
Vol 12 (2) ◽  
pp. 76-79 ◽  
Author(s):  
Therese K. Abboud ◽  
Michael J. Moore ◽  
Jerry Jacobs ◽  
Kazushige Murakawa ◽  
Manoutchehr Soraya ◽  
...  
Keyword(s):  
Cesarean Section ◽  
Blood Gases ◽  
Maternal Blood ◽  
Elective Cesarean Section ◽  
Control Group ◽  
Blood Levels ◽  
Acid Base ◽  
Apgar Scores ◽  
Elective Cesarean ◽  
Acid Base Status

The effects of epidural anesthesia using mepivacaine on maternal blood pressure, newborn Apgar scores, neonatal acid-base status, and the Early Neonatal Neurobehavioral Scale (ENNS) were studied in 21 pregnant women undergoing cesarean section. Maternal and neonatal blood levels of mepivacaine were also determined. Neonatal outcome was compared with a control group of 14 neonates of healthy mothers who received 3% 2-chloroprocaine for elective cesarean section. All patients had satisfactory anesthesia for cesarean section with an onset of 19 ± 1.8 minutes (mean ± SEM) and duration of 95 ± 11.9 minutes. Hypotension developed in two patients, and they were treated with intravenous ephedrine. All neonates had Apgar scores of 8 or more at 1 and 5 minutes and normal blood gases and acid-base status. None of the variables of the ENNS differed significantly between the mepivacaine and the chloroprocaine control group with the exception of truncal tone, which was significantly higher in the mepivacaine group ( p < 0.05). Mepivacaine was detected in all maternal and fetal samples, and the umbilical venous to maternal venous ratio was 0.57 ± 0.17 (mean ± SEM).

Prophylactic Angiotensin II Infusion during Spinal Anesthesia for Elective Cesarean Delivery 

1998 ◽  
Vol 88 (6) ◽  
pp. 1475-1479 ◽  
Author(s):  
Robert D. Vincent ◽  
Carol F. Werhan ◽  
Patricia F. Norman ◽  
Grace H. Shih ◽  
David H. Chestnut ◽  
...  
Keyword(s):  
Blood Pressure ◽  
Heart Rate ◽  
Angiotensin Ii ◽  
Systolic Blood Pressure ◽  
Spinal Anesthesia ◽  
Cesarean Delivery ◽  
Elective Cesarean Section ◽  
Elective Cesarean Delivery ◽  
Maternal Heart Rate ◽  
Elective Cesarean

Background Angiotensin II may prove useful in treating regional anesthesia-induced hypotension in obstetric patients, because it causes less uterine vasoconstriction than do other vasoconstrictor drugs (such as phenylephrine). This study compared (1) maternal blood pressure and heart rate and (2) fetal status at delivery in parturients given either prophylactic angiotensin II or ephedrine infusion during spinal anesthesia for elective cesarean delivery. Methods Fifty-four women were randomized to receive either angiotensin II or ephedrine infusion intravenously during spinal anesthesia for elective cesarean section delivery. Simultaneous with subarachnoid injection, infusion of angiotensin II (2.5 microg/ml) or ephedrine (5 mg/ml) was initiated at 10 ng x kg(-1) x min(-1) and 50 microg x kg(-1) x min(-1), respectively. The rate of each infusion was adjusted to maintain maternal systolic blood pressure at 90-100% of baseline. Results Cumulative vasopressor doses (mean+/-SD) through 10, 20, and 30 min were 150+/-100, 310+/-180, and 500+/-320 ng/kg in the angiotensin group and 480+/-210, 660+/-390, and 790+/-640 microg/kg in the ephedrine group. Maternal heart rate was significantly higher (P &lt; 0.001) during vasopressor infusion in the ephedrine group than in the angiotensin group. Umbilical arterial and venous blood pH and base excess were all significantly higher (P &lt; 0.05) in the angiotensin group than in the ephedrine group. Conclusions Angiotensin II infusion maintained maternal systolic blood pressure during spinal anesthesia without increasing maternal heart rate or causing fetal acidosis.

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