scholarly journals SALIVARY ALPHA-AMYLASE AS A PREDICTOR OF ARTERIAL HYPOTENSION DURING CESARESN SECTION UNDER SPINAL ANESTHESIA IN PRIMIPAROUS OF YOUNGER AGE

2017 ◽  
Vol 11 (4) ◽  
pp. 233-239
Author(s):  
Evgeniy N. Degtyarev ◽  
Y. M Shifman ◽  
G. P Tikhova
Keyword(s):  
Blood Pressure ◽  
Cesarean Section ◽  
Pregnant Women ◽  
Spinal Anesthesia ◽  
Kinetic Method ◽  
Arterial Hypotension ◽  
Anxiety And Depression ◽  
Operating Table ◽  
Percentage Increase ◽  
Clinically Significant

Arterial hypotension refers to the frequent complications of spinal anesthesia during cesarean delivery. Expressed anxiety before the operation of caesarean section, can contribute to the occurrence of arterial hypotension during CA. Juvenile pregnant women are characterized by a high level of anxiety. Determination of the level of α-amylase of saliva is a simple and non-invasive way of an objective assessment of the intensity of stress. Objective: To develop an algorithm for predicting arterial hypotension in spinal anesthesia during cesarean section in young primiparas. Materials and methods of research. After the approval of the ethical committee of the FSBU VO “Amurskaya GMA” of September 21, 2016. Clinical research on the topic “Anesthesia of delivery of young patients” conducted a prospective observational study of 43 pregnant women aged 14 to 18 years, on the basis of the regional perinatal center of GAUZ JSC “AOKB” in the period from 2016 to 2017. Primary endpoints of the study included a level of salivary α-amylase (AAS) recorded at resting patients (baseline level) and on the operating table immediately before anesthesia, as well as an assessment of anxiety and depression on the HADS scale performed on the eve of delivery. The parameters of hemodynamics (blood pressure and heart rate) were recorded on the eve of delivery, before performing spinal anesthesia, and the lowest level of blood pressure during the operation was noted. The level of α-amylase was determined by a Labio 200 (Mindray), using the “alfa-AMY” reagent, kinetic method on photometric systems. Results. In the presence of clinically significant anxiety on the HADS scale in the patient, the level of AAS before the operation increases by almost a quarter of the initial level, whereas in patients with anxiety scores less than 11 points, the percentage increase in AAS is 2 times less. The maximum decrease in blood pressure and blood pressure in patients during the operation of a cesarean section with an anxiety score above 11 points is on average 37-38% of the initial, while in patients with no clinically significant anxiety, the blood pressure increase is on average 17.5%. The difference between the mean absolute values of AAS levels at rest and before the operation in patients of the above 2 subgroups was also expressed. Сonclusion. The level of amylase has a strong associative relationship with the scale of anxiety and depression of HADS. The algorithm developed by us, which includes preoperative levels of salivary α-amylase and systolic blood pressure, allows us to predict the likelihood of intraoperative hypotension in a particular patient.

scholarly journals Hemodynamic effects of right pelvic wedge in patients undergoing elective cesarean section under spinal anesthesia

2018 ◽  
Vol 1 (2) ◽  
pp. 70-74
Author(s):  
Rohini Sigdel ◽  
Maya Lama ◽  
Sanish Gurung ◽  
Bishal Gurung ◽  
Anil Prasad Neupane ◽  
...  
Keyword(s):  
Cesarean Section ◽  
Spinal Anesthesia ◽  
Elective Cesarean Section ◽  
Controlled Study ◽  
Control Group ◽  
Operating Table ◽  
Hemodynamic Effects ◽  
Elective Cesarean ◽  
Spinal Hypotension ◽  
The Right

Background: Several methods have been used to prevent post spinal hypotension including preloading, co-loading, use of vasopressors, placement of pelvic wedge, lumbar wedge and tilting of operating table in parturients undergoing cesarean section. We conducted a randomized controlled study to determine the hemodynamic effects of a standard pelvic wedge placed below the right hip immediately after the spinal block till the delivery of baby. Methods: One hundred consenting women undergoing elective cesarean section under spinal anesthesia were randomly allocated to wedge group (N=50) and control group (N=50). A standard wedge was placed under the right pelvis soon after spinal anesthesia till the delivery of baby in wedge group whereas the control group remained supine. Hemodynamic parameters including blood pressure, heart rate, vasopressor consumption, other side effects like nausea, vomiting and neonatal outcome were also recorded. Results: The incidence of hypotension and bradycardia was similar between groups (Wedge group 60% vs Control group 75.51%, p=0.125) before the birth of baby. The use of vasopressors (p=0.212), incidence of nausea (p=0.346) and Apgar score at 1 and 5 minutes (p=0.629, p=0.442) were also not statistically significant. None of the patients had vomiting. Conclusion: In our study, the use of right pelvic wedge immediately after spinal anesthesia was not effective in preventing post spinal hypotension in elective cesarean section.

scholarly journals Spinal Anesthesia For Cesarean Section: A Comparison Of The Effects Of Right Lateral And Supine-Wedged Positions On Blood Pressure. 

2000 ◽  
Vol 2000 (4) ◽  
pp. NA-NA
Author(s):  
H Hartley ◽  
H Ashworth ◽  
M Kubli ◽  
G O'Sullivan ◽  
P Seed ◽  
...  
Keyword(s):  
Blood Pressure ◽  
Cesarean Section ◽  
Spinal Anesthesia

scholarly journals Efek Pemberian Cairan Koloid dan Kristaloid terhadap Tekanan Darah

2016 ◽  
Vol 12 (1) ◽  
pp. 19
Author(s):  
Rebika Nurul Azizah ◽  
Kenanga Marwan Sikumbang ◽  
Asnawati Asnawati
Keyword(s):  
Blood Pressure ◽  
Cesarean Section ◽  
Spinal Anesthesia ◽  
Diastolic Pressure ◽  
Statistical Test ◽  
Cross Sectional ◽  
Crystalloid Fluid

Abstract: Maternal hypotension is a serious problem that most commonly occurs after spinal anesthesia in cesarean section. To reduce the incidence of maternal hypotension, mother with spinal anasthesia for cesarean section can be given fluids intravenously using crystalloid or colloid.The purpose of this study was to determine the effect of colloid and crystalloid fluid to blood pressure in mother with spinal anesthesia for cesarean section. This study was cross sectional observational analytic. There were 2 groups in this study, crystalloid group and colloid group. Sampels in each group were 20 subject. Generalized linier models test showed the value of P > 0.05 for each hemodynamic markers (Systolic and diastolic pressure at 5th, 10th, and 15th minutes). On the statistical test value of systolic ( P= 0.379) and diastolic ( P= 0.654). It can be concluded that crystalloid and colloid fluid were equally efective to defend blood pressure in patients with spinal anesthesia for caesarean sectionKeywords: blood pressure, spinal anesthesia, cesarean section, crystalloid, colloid. Abstrak: Hipotensi pada ibu hamil adalah masalah serius yang paling umum terjadi pasca anestesi spinal pada seksio sesarea. Untuk mengurangi kejadian hipotensi tersebut dapat diberikan cairan intravena berupa kristaloid atau koloid. Tujuan penelitian ini untuk membandingkan efek penggunaan cairan koloid dan kristaloid terhadap tekanan darah pasien seksio sesaria dengan anestesi spinal. Penelitian ini bersifat observasional analitik cross sectional. Dua puluh pasien yang telah diberikan cairan kristaloid dan 20 pasien lainnya yang diberikan cairan koloid. Dari uji statistik dengan generaliz linier model didapatkan nilai P= >0.05 pada setiap penanda hemodinamik (TDS dan TDD pada menit ke-5, 10, dan 15). Pada uji statistik tersebut nilai TDS (P = 0.379) dan TDD (P = 0.654). Dapat disimpulkan bahwa cairan kristaloid dan koloid sama efektifnya dalam mempertahankan tekanan darah pada ibu hamil dengan seksio sesarea yang dilakukan anestesi spinal. Kata-kata kunci: tekanan darah, anestesi spinal, seksio sesarea, kristaloid, koloid.

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 Anesthetic management of obese and morbidly obese parturients

2021 ◽  
Vol 16 (4) ◽  
pp. 313-321
Author(s):  
Sang Tae Kim
Keyword(s):  
Cesarean Section ◽  
Pregnant Women ◽  
Spinal Anesthesia ◽  
Anesthetic Management ◽  
Operation Time ◽  
Rapid Onset ◽  
The Body ◽  
Morbidly Obese ◽  
Single Shot ◽  
Cesarean Sections

The prevalence of obese parturients is increasing worldwide. This review describes safe analgesic techniques for labor and anesthetic management during cesarean sections in obese parturients. The epidural analgesic technique is the best way to provide good pain relief during the labor phase and can be easily converted to a surgical anesthetic condition. However, the insertion of the epidural catheter in obese parturients is technically more difficult compared to that in non-obese parturients. The distance from the skin to the epidural space increases in proportion to the body mass index (BMI): 4.4 cm in mothers of normal weight and 7.5 cm in mothers with BMI 50 and above. Neuraxial blocks are the ideal anesthetic methods and gold standard techniques for cesarean section in pregnant women with obesity. Single-shot spinal anesthesia is the most common type of anesthesia used for cesarean sections. The advantage of single-shot spinal anesthesia is a dense-sufficient block of rapid onset. A combined spinal-epidural (CSE) anesthetic technique is also recommended as an attractive alternative method. In obese parturients, the operation time can be longer than expected, and therefore, the CSE technique provides the advantage of rapid onset and intense block for prolonged operation with postoperative pain control. The risk of postoperative complications is very high in obese parturients. Therefore, detailed communication of the parturient's medical condition and the details of surgery and anesthesia between the anesthesiologist and obstetrician is important prior to cesarean section in obese pregnant women.

Sign in / Sign up

Export Citation Format

Share Document