scholarly journals Successful Spinal Anaesthesia in Patient of Achondroplasia Undergoing Lower Segment Cesarean Section

2015 ◽  
Vol 4 (12) ◽  
pp. 2040-2042
Keyword(s):  
Cesarean Section ◽  
Spinal Anaesthesia ◽  
Lower Segment ◽  
Lower Segment Cesarean Section

scholarly journals Efficacy of Equal Volume of Ringer Lactate Versus 3.5% Polymer of Degraded Gelatine Solution (Haemaccel) as Preloading Fluid for Prevention of Hypotension after Spinal Anaesthesia for Lower Segment Cesarean Section

2012 ◽  
Vol 10 (1) ◽  
pp. 1-5
Author(s):  
BR Kunwar ◽  
P Bhattacharyya ◽  
NB KC
Keyword(s):  
Body Weight ◽  
Cesarean Section ◽  
Spinal Anaesthesia ◽  
Relative Volume ◽  
Ringer Lactate ◽  
Lower Segment ◽  
Lower Segment Cesarean Section ◽  
Short Period ◽  
Group A ◽  
Group B

Introduction: Systemic hypotension is frequently and immediately seen after spinal anaesthesia. Historically Ringer lactate is used to substitute the acute relative volume loss after spinal anesthesia, although it remains in intravenous circulation for a short period. The preloading with 5% albumin and gelatine have become popular and effective as they remain intravascular for a longer duration providing sustained normotension. The aim of this study was to assess the efficacy of equal volume of Ringer lactate and Haemaccel as a preloading fluid for the prevention of hypotension after spinal anaesthesia in patients undergoing Lower Segment Cesarean Section. Methods: This was a prospective comparative study in which Patients were randomly allocated in to Group A and group. Group A patients were preloaded with Ringer lactate 10ml/kg body weight and Group B were preloaded with Haemaccel 10 ml/kg body weight within a period of 5-10 minutes before spinal anaesthesia. After giving the block, blood pressure (systolic, diastolic and mean) were recorded every 2.5 minutes for initial 20 minutes and every 5 minutes during the rest of the period of surgery. Onset of hypotension along with other parameters were recorded and analysed using SPSS ver. 13. Results: All together 100 patients were enrolled in the study, 50 in Group A (Ringer lactate) and 50 in Group B (Haemaccel). The episodses of hypotension was higher in patients who received Ringer lactate as preloading fluid than who received haemaccel as preloading fluid (42% versus 24%). Conclusion: Preloading with Haemaccel gives better hemodynamic stability and lesser incidence of hypotension than that of Ringer lactate. DOI: http://dx.doi.org/10.3126/mjsbh.v10i1.6405 Medical Journal of Shree Birendra Hospital Jan-June 2011 10(1) 1-5

A COMPARISON OF LEFT UTERINE DISPLACEMENT USING CLINOMETER GUIDED TABLE TILT VS CONVENTIONAL CRAWFORD WEDGE DURING SPINAL ANAESTHESIA IN CESAREAN SECTION- A PROSPECTIVE RANDOMIZED STUDY

2021 ◽  
pp. 7-9
Author(s):  
Jeya Pratheef Muthiah ◽  
Senthil Kumar. N
Keyword(s):  
Cesarean Section ◽  
Spinal Anaesthesia ◽  
Vena Cava ◽  
Gravid Uterus ◽  
Lower Segment ◽  
Subarachnoid Block ◽  
Lower Segment Cesarean Section ◽  
The Impact ◽  
Surgeon Satisfaction ◽  
Aortocaval Compression

INTRODUCTION: Enlarged gravid uterus causing aortocaval compression may decrease the venous return and cause maternal hypotension. Maternal position after neuraxial blockade may exacerbate the impact of aortocaval compression and consequences on cardiovascular instability. Left uterine displacement (LUD) after spinal anaesthesia in lower segment cesarean section is essential in preventing supine hypotension syndrome. Decreased cardiac output secondary to vena cava obstruction by the gravid uterus can be prevented by lateral tilt position. AIM OF THE STUDY: This study is therefore designed to evaluate the role of leftward uterine displacement by table tilt using clinometer software or by using crawford wedge tilt and compare the effects on hemodynamics in parturient undergoing lower segment cesarean section (LSCS) under subarachnoid block MATERIALS AND METHODS: The study was carried out in the Department of Anaesthesiology involving Department of Obstetrics and gynecology in Kanyakumari Government Medical College from January 2018 to June 2019. Patients were allocated into two groups by randomization. After spinal anaesthesia parturient in Group T: Lateral Table Tilt by using clinometer -15 degree- (40 parturient). Parturient in Group W: Crawford wedge Tilt- (40 parturient). Patients, age, body weight, BMI and baseline vital parameters were recorded. Incidence of hypotension after spinal anaesthesia in a cesarean section, Total dose Vasopressor required, Level of blockade, APGAR Score, Surgeon satisfaction grading. RESULTS: The demographic parameters like age, height, weight, BMI and the indication for surgery were similar in both groups. There were no difference in mean height level of block between both groups. In comparison of hypotensive incidence in both groups, the high incidence noted in the GROUP W (wedge group) (35%) is higher than the incidence in GROUP T (table tilt) nd th th (7.5%). The incidence of hypotension is signicantly noted at 2 , 4 , 5 minute after the subarachnoid block in wedge group compared to the table tilt group. The dose of vasopressor requirements and average ephedrine dose used is less in GROUP T (table tilt) (0.6±2.3mg) compared to GROUP W (wedge) (3.9±5.7 mg). In comparison of surgeon satisfaction between both groups, surgeons are much satised with the wedge group patient and found difcult, disturbing and sometimes unbearable st th while perform the surgery for the patient in table tilt. The APGAR Scores in GROUP W at 1 minute and 5 minute is (7.3±0.5 and st th 8.7 ±0.5) respectively which are relatively satisfactory compared to the GROUP T (6.8±0.6 and 8.3±0.6) at 1 and 5 minute. CONCLUSION: Table tilt provide a good relief from inferior vena cava and aortocaval compression when compared to the wedge placed under the right hip during cesarean section done under subarachnoid block. Using the wedge is easier and 0 surgeons at our institute found it more comfortable than the table tilt to 15 but anesthetists feel better with table tilt because there is little incidence of hemodynamic variation. We conclude that all the parturient posted for caesarean section should be 0 given a table tilt of 15 placed with angle measured exactly by clinometer to decrease incidence of hypotension occurring due to aortocaval compression

scholarly journals Epigastric pain after intravenous administration of oxytocin in patients undergoing lower segment cesarean section: A quasi experimental study comparing intravenous bolus with infusion technique

2020 ◽  
Vol 24 (1) ◽  
pp. 50-53
Author(s):  
Ali Kashif ◽  
Rizwana Bashir Kiani ◽  
Syed Muhammad Asad Shabbir ◽  
Tariq Mahmood ◽  
Ghulam Sabir ◽  
...  
Keyword(s):  
Experimental Study ◽  
Cesarean Section ◽  
Epigastric Pain ◽  
Intravenous Bolus ◽  
Lower Segment ◽  
Lower Segment Cesarean Section ◽  
Quasi Experimental ◽  
Group A ◽  
Group B ◽  
Infusion Technique

Aim: To compare the frequency of epigastric pain and uterotonic effect of an equivalent dose of oxytocin administered as an intravenous bolus versus intravenous infusion during elective LSCS under spinal anesthesia. Methodology: We recruited 98 parturients undergoing elective LSCS under spinal anesthesia for this prospective quasi experimental study and divided them into two groups. Group-A received 5 IU of oxytocin as bolus intravenous (IV) injection in 5 sec (bolus group, n= 48), and Group-B (infusion group, n= 50) received 5 IU of oxytocin as an infusion over 5 min. Any complaint of epigastric pain by the patients was noted and its frequency was compared between the two groups. The uterine tone was assessed as adequate or inadequate by an obstetrician. The data were entered into SPSS version 22. Patient demographic data were analyzed with independent samples T-test and the study data were analyzed with Chi‑square test and presented as n (%). p < 0.05 was considered statistically significant. Results: Epigastric pain was noted in 25 (52.03%) out of 48 parturients in Group-A and 15 (30%) out of 50 in Group-B (p = 0.026). There was no significant difference in the uterotonic effect of oxytocin between the two groups (p = 0.736). Conclusion:  We conclude that oxytocin infusion is associated with lower frequency of epigastric pain in elective LSCS when compared to intravenous bolus of an equivalent dose of oxytocin, However, the effect on uterine contractions was adequate with both methods. Citation: Kashif A, Kiani RB, Shabbir SMA, Mahmood T, Sabir G, Fatima NE, Khan WA. Epigastric pain after intravenous administration of oxytocin in patients undergoing lower segment cesarean section: A quasi experimental study comparing intravenous bolus with infusion technique. Anaesth pain intensive care 2020;24(1):_ DOI: https://doi.org/10.35975/apic.v2i1. Received – 20 February 2019; Reviewed – 4, 16 March, 25 June, 9 September, 2, 25 November, 10 December 2019, 7 January 2020; Revised – 19 June, 10 August, 29 September, 1 November 2019, 6 January 2020; Accepted – 10 January 2020;

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