Effect of Continuous Prophylactic Administration of Phenylephrine on Hypotension during Cesarean Section under Spinal Anesthesia

Background: Shivering refers to a series of repetitive involuntary movements of the skeletal muscles commonly occurring during spinal anesthesia. Regional anesthesia (both spinal and Epidural) reduces vasoconstriction and shivering threshold to 6 degrees Celsius above the surface of the block. The aim of this study was to determine the effect of prophylactic administration of intravenous paracetamol in controlling shivering during and after cesarean section under spinal anesthesia. Methods: In a double-blind randomized clinical trial in the Department of Anesthesiology of Tabriz on patients undergoing cesarean section with spinal anesthesia, the effect of prophylactic administration of paracetamol IV in controlling shivering during and after cesarean section under spinal anesthesia was evaluated. Results: The mean gestational age of patients was 37.94±1.07 weeks in paracetamol group and 37.58±2.07 weeks in the control group (p=0.278). The mean shivering scores of patients in paracetamol group were 0.72±0.80 in the operating room and 1.32±1.05 in recovery room (P<0.001). The mean shivering scores of patients in control group were 1.16±1.07 in the operating room and 2.28±1.45 in recovery room (P<0.001). The mean increase of shivering score in patients was 0.60±0.98 in paracetamol group and 1.12±1.46 in the control group. The mean increase of shivering score in patients in paracetamol group was significantly less than the control group (p=0.041). Conclusion: In the present study, the prophylactic use of intravenous acetaminophen reduced the rate of increase of shivering in patients after spinal anesthesia. Postoperative complications in patients in paracetamol group was less than the control group, however, this difference was not statistically significant.

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Toward an advisory system for cesarean section spinal anesthesia

Proceedings of the 2004 American Control Conference ◽

10.23919/acc.2004.1383730 ◽

2004 ◽

Author(s):

P. Fung ◽

G. Dumont ◽

M. Ansermino ◽

M. Huzmezan ◽

A. Kamani

Keyword(s):

Cesarean Section ◽

Spinal Anesthesia ◽

Advisory System

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Scenario of General Anesthesia for Cesarean Section in Rural Tertiary Care Center in High Altitude Karnali Academy of Health Sciences

Journal of College of Medical Sciences-Nepal ◽

10.3126/jcmsn.v16i3.32751 ◽

2020 ◽

Vol 16 (3) ◽

Author(s):

Ramesh Bhattarai ◽

Rajiv Shah ◽

Sita Dhakal ◽

Pragya Malla ◽

Srijana Sapkota

Keyword(s):

Cesarean Section ◽

General Anesthesia ◽

High Altitude ◽

Spinal Anesthesia ◽

Neonatal Outcome ◽

Care Center ◽

Tertiary Care ◽

Health Sciences ◽

Tertiary Care Center ◽

Cord Prolapse

Background: General anesthesia for cesarean section is being less popular for cesarean section in present days but sometime general anesthesia is inevitable. The aim of the study is to assess the trends of general anesthesia, indications, clinical outcome in mother and fetus in high altitude setting of tertiary care center of Nepal. Methods: We conducted descriptive cross-sectional study all cases of cesarean section in Karnali Academy of health Sciences (KAHS) located at high altitude over three years period in our institute. Data were retrieved from the hospital records during three fiscal year (Jan 1st 2017 to Jan Dec 31st 2019). The record of all the patients who underwent cesarean section under general anesthesia was reviewed for demographic details, indication of general anesthesia, trends for general and spinal anesthesia and maternal and neonatal outcome. Results: Out of total deliveries 2175, 309 (14.2%) cases account for cesarean section. Among them, 52 (17%) required general anesthesia . Eclampsia 19(36%) remain the major indication for General Anesthesia in cesarean section followed by failure of spinal anesthesia number 14 (26%) , cord prolapse six (12%), antepartam haemorrhage five (10%), spinal site infection four (8%), Khiphoscoliosis two(4%), Patients request two (4%). Use for general anesthesia technique was consistent for three years with slow rise in use of spinal anesthesia . There was no any anesthesia related maternal mortality and nine intraoperative neonatal Conclusions: General anesthesia practices are consistently required in rural high-altitude setup. Eclampsia is the commonest indication followed by failure of spinal anesthesia and cord prolapse. Neonatal outcome is still not good.

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

Current Clinical Pharmacology ◽

10.2174/1574884715666200302122800 ◽

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.

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