scholarly journals Perioperative Outcomes in COVID-19 Obstetric Patients Undergoing Spinal Anesthesia for Cesarean Section: A Prospective Observational Study

Healthcare ◽  
2021 ◽  
Vol 10 (1) ◽  
pp. 23
Author(s):  
Omar Ababneh ◽  
Mustafa Alrabayah ◽  
Ahmad I. El-Share’ ◽  
Isam Bsisu ◽  
Yara Bahar ◽  
...  
Keyword(s):  
Spinal Anesthesia ◽  
Operating Conditions ◽  
Perioperative Outcomes ◽  
Anesthetic Technique ◽  
Control Group ◽  
Spinal Block ◽  
Sensory Level ◽  
Emergency Cesarean ◽  
Tertiary Teaching ◽  
Significant Difference

Coronavirus disease 2019 (COVID-19) adds more challenges to the perioperative management of parturients. The aim of this study is to examine perioperative adverse events and hemodynamic stability among COVID-19 positive parturients undergoing spinal anesthesia. This prospective observational investigation was conducted at a tertiary teaching hospital in Jordan between January and June 2021, during which 31 COVID-19 positive parturients were identified. Each COVID-19 positive parturient was matched with a COVID-19 negative parturient who received anesthesia under similar operating conditions as a control group. Of the 31 COVID-19 patients, 22 (71%) were otherwise medically free, 8 (25.8%) were emergency cesarean sections. The sensory level of spinal block after 10 min was T8 (T6–T10) among COVID-19 positive group, compared to T4 (T4–T6) among control group (p = 0.001). There were no significant differences in heart rate, SBP, DBP, and MAP intraoperatively (p > 0.05). Twelve (36.4%) neonates born to COVID-19 positive patients were admitted to NICU, compared to four (11.8%) among control group (p = 0.018). There was no statistically significant difference in postoperative complications. In conclusion, spinal anesthesia is considered a safe anesthetic technique in COVID-19 parturients, and therefore it is the anesthetic method of choice for cesarean deliveries among COVID-19 patients.

scholarly journals Assessment of Maternal Satisfaction and Associated Factors among Parturients Who Underwent Cesarean Delivery under Spinal Anesthesia at University of Gondar Comprehensive Specialized Hospital, Northwest Ethiopia, 2019

2020 ◽  
Vol 2020 ◽  
pp. 1-8
Author(s):  
Samuel Debas Bayable ◽  
Seid Adem Ahmed ◽  
Girmay Fitiwi Lema ◽  
Debas Yaregal Melesse
Keyword(s):  
Logistic Regression ◽  
Spinal Anesthesia ◽  
Cesarean Delivery ◽  
Associated Factors ◽  
Northwest Ethiopia ◽  
Anesthetic Technique ◽  
Spinal Block ◽  
Maternal Satisfaction ◽  
Cross Sectional ◽  
Multivariable Logistic Regression

Background. Spinal anesthesia is the most common anesthetic technique for cesarean delivery. Patient satisfaction is a subjective and complicated concept, involving physical, emotional, psychological, social, and cultural factors. Regular evaluation of maternal satisfaction related to anesthesia service is an important parameter to the required changes and expansion of high-quality care services. We aimed to assess maternal satisfaction and associated factors among parturients who underwent cesarean delivery under spinal anesthesia. Methods. Institutional-based cross-sectional study was conducted from February to May 2019. A total of 383 parturients were enrolled to assess maternal satisfaction using a 5-point Likert scale. Both bivariable and multivariable logistic regression analyses were done. Variables of p value ≤0.2 in the bivariable analysis were a candidate for multivariable logistic regression. A p value <0.05 was considered as significantly associated with maternal satisfaction at 95% CI. Results. This study revealed that 315 (82.3%) of the parturients were satisfied. Single spinal prick attempts (AOR = 2.08, 95% CI = 1.05–4.11), successful spinal block (AOR = 7.17, 95% CI = 3.33–15.43), less incidence of postdural puncture headache (AOR = 2.36, 95% CI = 1.33–4.20), and prophylactic antiemetic use (AOR = 0.35, 95% CI = 0.19–0.66) were positively associated with maternal satisfaction. Conclusions. The overall maternal satisfaction receiving spinal anesthesia was considerably low. Single spinal prink attempts, successful spinal block, and less incidence of postural puncture headache can increase maternal satisfaction. Therefore, effective perioperative management, skillful techniques, and using the small-gauge Quincke spinal needle (25–27 gauge) may increase the maternal satisfaction and quality of spinal anesthesia management.

scholarly journals Efficacy and safety of intrathecal morphine for post cesarean section analgesia

2015 ◽  
Vol 1 (1) ◽  
pp. 13-17
Author(s):  
Rupesh Kumar Gami ◽  
Kumar Jahan ◽  
Chandra Bhushan Jha
Keyword(s):  
Cesarean Section ◽  
Spinal Anesthesia ◽  
Visual Analog Scale ◽  
Intrathecal Morphine ◽  
Safe Motherhood ◽  
Control Group ◽  
Efficacy And Safety ◽  
Analog Scale ◽  
Morphine Group ◽  
Significant Difference

Background: Government of Nepal has been conducting Cesarean section under “Safe Motherhood” program all over country. The purpose of this study was to evaluate the efficacy and safety of intrathecal morphine for post cesarean analgesia under spinal anesthesia.  Methods: A total of 300 parturients posted for Cesarean section under spinal anesthesia were divided into two groups of 150 each in this prospective randomized case-control study. Morphine group received 0.15 mg of intrathecal morphine mixed in 12 mg of 0.5% bupivacaine heavy while control group received 12 mg of 0.5% bupivacaine heavy alone, after proper preparation of spinal anesthesia. The parturients were assessed for first request of analgesic as per Visual Analog Scale, frequency of analgesics required within 24 hr, nausea, vomiting, pruritus, sedation and respiratory depression.Results: Postoperative analgesia was significantly greater in morphine group as compare to control group (12.1 ± 7.6 vs 3.7 ± 2.9 hr). Frequency of analgesics requirements was also significantly lower in morphine group (1.7 ± 2.0 vs 3.4 ± 8.1). Visual Analog Scale was below 4 at most of time in morphine group. The incidence of nausea, vomiting and pruritus were more in morphine group as compare to control group but without any respiratory depression. There was no significant difference in APGAR score among fetus.  Conclusion: Mixing low dose of intrathecal morphine in standard dose of spinal anesthesia effectively prolongs the duration of post cesarean analgesia and decreases the frequency of analgesics requirement without any major complication in parturients or fetus.Journal of Society of Anesthesiologists 2014 1(1): 13-17

Standard Anesthetic Technique for Middle Ear Surgical Procedures: A Comparison of Desflurane and Sevoflurane

2005 ◽  
Vol 133 (2) ◽  
pp. 269-274 ◽  
Author(s):  
W. Scott Jellish ◽  
Kevin Owen ◽  
Steven Edelstein ◽  
Elaine Fluder ◽  
John P. Leonetti
Keyword(s):  
Middle Ear ◽  
Operating Conditions ◽  
Anesthetic Technique ◽  
Middle Ear Surgery ◽  
Pain Scores ◽  
Significant Difference ◽  
Discharge Readiness ◽  
History Of ◽  
Blood Pressures ◽  
To Receive

Objective: This study was designed to compare desflurane and sevoflurane anesthesia for middle ear microsurgery. Study Design: One hundred healthy adults undergoing middle ear surgery were assigned to receive either desflurane or sevoflurane as their anesthetic. Intraoperative hemodynamics and BIS numbers were recorded. Hemodynamics, pain, nausea/vomiting, discharge readiness, and other parameters were compared postoperatively and 24 hours later. Results: No intraoperative differences were noted except in BIS scores which trended lower with desflurane. PACU blood pressures were higher after desflurane but pain scores, nausea/vomiting, rescue anti-emetics, recovery scores, and discharge times were similar. A significant difference was noted in anesthetic costs (desflurane > sevoflurane), and in patients with the lowest BIS scores associated with more nausea/vomiting. Conclusions: Both anesthetics may be used for ototic surgery but propofol anesthesia should still be considered in patients with a history of emetic sequelae. Significance: Short-acting inhalational anesthetics produce excellent operating conditions and reduce costs for otologic surgery.

scholarly journals Comparison of hemodynamic effect between the spinal anesthesia and saddle block during transurethral resection of the prostate

2021 ◽  
Vol 23 (09) ◽  
pp. 817-828
Author(s):  
Dr. Farooq Taher Abdulqader ◽  
◽  
Dr. Ali Abd-Alhameed Mohammed ◽  
Keyword(s):  
Spinal Anesthesia ◽  
Transurethral Resection ◽  
Major Complication ◽  
Hemodynamic Effect ◽  
Spinal Block ◽  
Transurethral Resection Of Prostate ◽  
Hyperbaric Bupivacaine ◽  
Significant Difference ◽  
Group A ◽  
Group B

Background: The best technique for transurethral resection of prostate (TURP) is regional anesthesia. The hypotension is the major complication following spinal anesthesia. The hemodynamic changes is less with saddle block than spinal block. Aim and Objective: To compare hemodynamic effect between the spinal block and saddle block in TURP. Patients and methods: 50 patients between 50-70 years old ASA I – II prepared for TURP, divided randomly in two groups 25 pt. in each group. Group A received spinal 10 mg of hyperbaric bupivacaine (2 ml of 0.5%), were group B received saddle block 10 mg of hyperbaric bupivacaine (2 ml of 0.5%). The blood pressure, oxygen saturation, heart rate measured and recorded subsequently. The hypotension treated by 100 mcg bolus of phenylephrine. Results: In our study there was statically significant difference (p < 0.05) between group A which received spinal anesthesia and group B which received saddle block in hemodynamic effect. In which the incidence of hypotension and vasopressor requirement more in group A. Conclusion: Under saddle block the TURP can safely performed with low risk of hypotension and less requirement of vasopressor.

CLONIDINE AS AN ADJUVANT TO HYPERBARIC BUPIVACAINE FOR SPINAL ANESTHESIA IN ELDERLY PATIENTS UNDERGOING INFRAUMBLICAL SURGERIES

2021 ◽  
pp. 72-74
Author(s):  
Purushottam Singhal ◽  
Suresh Pandey ◽  
. S. P. Chittora
Keyword(s):  
Blood Pressure ◽  
Elderly Patients ◽  
Systolic Blood Pressure ◽  
Spinal Anesthesia ◽  
Sensory Block ◽  
Primary Study ◽  
Control Group ◽  
Sensory Level ◽  
Hyperbaric Bupivacaine ◽  
Small Doses

Background: Use of adjuvant with small doses of local anesthetics is a preferred technique for spinal anesthesia for lower limb surgeries. This study tested the hypothesis that addition of small doses of clonidine augments the spinal block levels produced by hyperbaric bupivacaine in patients without affecting the side-effects. Materials and Methods: This was a prospective, randomized, double-blind study. Above 60 years patients were allocated to three equal groups. Group C received 10 mg hyperbaric bupivacaine without clonidine while Group C and Group C received 15 μg and 30 μg clonidine with 15 30 hyperbaric bupivacaine respectively for spinal anesthesia. Effect of clonidine on sensory block levels was the primary study outcome measure. Motor blockade and hemodynamic parameters were also studied. Results:Asignicantly higher median block levels were achieved in Group C (P < 0.05) and Group C (P <0.05) than Group C. Highest median 15 30 sensory block level, the mean times for sensory regression to T12 level and motor block regression were statistically signicant between Groups C15 and C and between Groups C and C. On comparison of fall in systolic blood pressure trends, there was no signicant difference in the clonidine 30 groups as compared with the control group. Conclusions: In elderly patients, clonidine when used intrathecally in doses of 15 μg or 30 μg with bupivacaine, signicantly potentiated the sensory block levels and duration of analgesia without affecting the trend of systolic blood pressure as compared to bupivacaine alone. Clonidine in doses of 30 μg however facilitated the ascent of sensory level block to unexpectedly higher dermatomes for a longer time.

scholarly journals Electroacupuncture for Bladder Function Recovery in Patients Undergoing Spinal Anesthesia

2014 ◽  
Vol 2014 ◽  
pp. 1-6 ◽  
Author(s):  
Yinqiu Gao ◽  
Xinyao Zhou ◽  
Xichen Dong ◽  
Qing Jia ◽  
Shen Xie ◽  
...  
Keyword(s):  
Adverse Events ◽  
Spinal Anesthesia ◽  
Urinary Retention ◽  
Urine Volume ◽  
Bladder Function ◽  
Control Group ◽  
Postoperative Urinary Retention ◽  
Function Recovery ◽  
Significant Difference ◽  
Secondary Endpoints

Purpose. To determine the efficacy of electroacupuncture on recovering postanesthetic bladder function.Materials and Methods. Sixty-one patients undergoing spinal anaesthesia were recruited and allocated into electroacupuncture or control group randomly. Patients in electroacupuncture group received electroacupuncture therapy whereas ones in control group were not given any intervention. Primary endpoint was incidence of bladder overdistension and postoperative urinary retention. Secondary endpoints included time to spontaneous micturition, voided volume, and adverse events.Results. All patients (31 in electroacupuncture group and 30 in control group) completed the evaluation. During postoperative follow-up, patients in electroacupuncture group presented a significant lower proportion of bladder overdistension than counterparts in control group (16.1% versus 53.3%,P< 0.01). However, no significant difference was found in incidence of postoperative urinary retention between the two groups (0% versus 6.7%,P> 0.05). Furthermore, a shorter time to spontaneous micturition was found in electroacupuncture group compared to control group (228 min versus 313 min,P< 0.001), whereas urine volume and adverse events had no significant difference between the two groups.Conclusions. Electroacupuncture reduced the proportion of bladder overdistension and shortened the time to spontaneous micturition in patients undergoing spinal anesthesia. Electroacupuncture may be a therapeutic strategy for postanesthetic bladder dysfunction.

scholarly journals Posterior Spinal Anesthesia for Bilateral Calcaneous Fracture in Cardiac Patients: A Case Report

2018 ◽  
Vol 3 (1) ◽  
Keyword(s):  
Case Report ◽  
Spinal Anesthesia ◽  
Motor Block ◽  
Nyha Class ◽  
Lower Limbs ◽  
Cardiac Patients ◽  
Spinal Block ◽  
Sensory Level ◽  
Routine Monitoring ◽  
Fracture Of The Calcaneus

Background: The calcaneal is more likely bone to be fractured between the tarsus bone. We report a case of a posterior spinal anesthesia without any degree of motor block, for a bilateral calcaneous fracture in cardiac patients. Case Report: A 51-year-old male (height 1.70 m, weight 75 kg, ASA II), cigarette smoking, diabetes, hypertension, was admitted for treatment of bilateral fracture of the calcaneus. Chest X-ray were normal. ECG showed left bundle branch block. Heat disease with congestive heart failure NYHA class II treated with captopril 50 mg, amiodarone 200 mg, spinolactone 25 mg, caverdilol 12.5 mg and furosemide 40 mg. The blood examination revealed: red blood cells (4,290,000/mm3 )), hemoglobin (15.3 g/dL) and hematocrit (42.8%). Routine monitoring. Spinal puncture was performed with the patient in the prone position, in the L2 -L3 interspaces using 26 G Quincke. After appearance of cerebrospinal fluid (CSF) 6 mg of 0.15% hypobaric bupivacaine were administered at a speed of 1 mL.15s-1, obtaining sensory level at T10 and no motor block of limbs. The operation lasted 50 minutes and was maintained during surgery motor function of lower limbs, without hypotension, bradycardia or decreased oxygen saturation. Bilateral sciatic nerve block was performed in the popliteal region with neurostimulator and needle A50 and injection of 20 mL of 0.2% levopubivacaine on each nerve for postoperative analgesia. Conclusions: The main advantage of this method of spinal block for this procedure includes hemodynamic stability, patient satisfaction with the absence of motor block in the lower limbs, fast recovery and no urinary retention. In addition, the patient is already anesthetized in the position in which he will be operated (ventral decubitus).

scholarly journals Phenylephrine Effectiveness in Handling Hypotensive Issues During Spinal Anesthesia Conductance for Cesarean Section Deliveries

2019 ◽  
Vol 4 (3) ◽  
Keyword(s):  
Cesarean Section ◽  
Spinal Anesthesia ◽  
Research Group ◽  
Elective Cesarean Section ◽  
Control Group ◽  
P Values ◽  
Management Protocol ◽  
Significant Difference ◽  
Elective Cesarean ◽  
The Impact

Background: Hypotension is frequent clinical challenge during spinal mode of anesthetic induction for cesarean delivery. Requiring an effective and prompt management mode since it has unfavorable clinical outcomes such as hemodynamic cardiovascular instability issues besides reduced uteroplacental perfusion. Aim: Investigating the impact and effectiveness of different prophylacticdosages of Phenylephrine on hypotensive issues during spinal anesthesia for cesarean section deliveries. Methodology:A prospective, randomized, clinical research study involved 184 cases That are classified as American Society of Anesthesiologists physical status I and II with term singleton pregnancies scheduled for elective cesarean section under spinal anesthesia randomized to receive 0.9% saline 2 mL (Control Group) or phenylephrine1.0 ug/kg (PHE1 research Group), 1.5 ug/kg (PHE1.5 research Group), or 2.0 ug/kg (PHE2 research Group) immediately after induction of spinal anesthesia. Results: The adverse effects of prophylactic bolus ofPhenylephrine among the research groups control, Phenylephrine 1, 1.5,2 in which there was statistically significant difference as regards hypotension, rescue Phenylephrine,lowest SBP,highest SBP,early highest SBP,mean SBP, occurrence of hypertension (p values= <0.001, <0.001, 0.002, <0.001, <0.001, <0.001, <0.001consecutively) there was no statistical significant difference as regards nausea and bradycardia (p values=0.929, 0.823consecutively). Conclusions: The research findings obtained denote and imply that a prophylactic Phenylephrine 1.5 ug/kg bolus followed by additional boluses when necessary could be an alternative management protocol to decrease the frequency of hypotensive issues occurrence during spinal anesthetic mode for cesarean deliveries.

scholarly journals Management of Shivering in Post-Spinal Anesthesia Using Warming Blankets and Warm Fluid Therapy

Jurnal NERS ◽  
2020 ◽  
Vol 14 (3) ◽  
pp. 305
Author(s):  
Arina Qona'ah ◽  
Novi Enis Rosuliana ◽  
I Made Amartha Bratasena ◽  
Wahyu Cahyono
Keyword(s):  
Body Temperature ◽  
Spinal Anesthesia ◽  
Fluid Therapy ◽  
T Test ◽  
The Body ◽  
Perioperative Outcomes ◽  
Control Group ◽  
Warming Blanket ◽  
Equivalent Control ◽  
The Mean

Hypothermia is a common and serious complication of spinal surgery and it is associated with many harmful perioperative outcomes. The aim of this study was to compare the effectiveness of warming blankets and warm fluid therapy to manage shivering. A quasi-experiment with a non-equivalent control group was applied as the research design. There were 60 patients involved in the study. The instrument of this study was a warmer fluid modification, a warming blanket and a cotton blanket. The data was analyzed using an applied paired t-test and independent t-test. After 60 minutes of the intervention, the mean and SD of body temperature of the patients receiving warm fluids was 36.71 ± 0.18, a warming blanket was 36.12 ± 0.35, and the control group was 35.76 ± 0.22. The p values were 0,000. Warm fluid therapy and warming blankets are significant in terms of increasing the body temperature of post-spinal anesthesia patients. Warm fluids are more effective than warming blanket. Warming blankets and warm fluid therapy can be used as a way to increase the body temperature of patients with hypothermia.

scholarly journals Comparison of commonly used vasopressors for treating hypotension after spinal anaesthesia in elective lower abdominal surgery: a randomized, observational, case-control study

2019 ◽  
Vol 7 (5) ◽  
pp. 1479
Author(s):  
Pradeep Kumari ◽  
Sifna Tahir ◽  
Haveena Kumari ◽  
Altaf Ahmad Mir
Keyword(s):  
Blood Pressure ◽  
Caesarean Section ◽  
Spinal Anesthesia ◽  
Elective Caesarean Section ◽  
Spinal Block ◽  
Hyperbaric Bupivacaine ◽  
Time Intervals ◽  
Significant Difference ◽  
Single Bolus Dose ◽  
The Mean

Background: During caesarean section hypotension due to spinal block is secondary to the sympathetic blockade and aorto-caval compression by the uterus. It can have important consequences for the mother and may affect neonatal outcome. The present study was aimed to compare intravenous bolus doses of phenylephrine and ephedrine to treat maternal hypotension during spinal block for elective caesarean section.Methods: After fulfilling the inclusion criteria, 100 parturient were randomly allocated into two groups of fifty each. For spinal anesthesia lumber puncture was done and 12.5mg, 0.5% hyperbaric bupivacaine was given intra-thecally. In this observational study, patients who developed hypotension under spinal anesthesia were selected for the study. According to their group, patients received either ephedrine 6mg (Group E) or phenylephrine 75µg (Group P) as vasopressor. During the study, number of vasopressor boluses, hemodynamic response and time taken to recover from hypotension was noted.Results: Ephedrine and phenylephrine were used in the mean doses of 6.72±1.97mg and 91.5±31.38µg respectively. In 88% parturient single bolus dose of ephedrine was effective in treating hypotension while phenylephrine was effective in 78% parturient. There was no significant difference observed in total number of boluses used. No significant difference was seen in mean systolic blood pressure, mean diastolic blood pressure and mean arterial pressure over a given period of time in Group E and Group P. Mean systolic BP was less than 20% when compared to baseline in both the groups at different time intervals. In Group P the mean heart rate was significantly lower as compared to the Group E (p<0.05).Conclusions: Intravenous phenylephrine and ephedrine are both similar in performance in treating hypotension after spinal anesthesia for elective caesarean section and the hypotensive control offered is comparable.

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