Hemodynamic Effects of Spinal Anesthesia for Cesarean Section are Equivalent in Severely Preeclamptic and Healthy Parturients

Author(s):  
Florentino Fernandes Mendes ◽  
Gustavo Hennemann ◽  
Ana Luft ◽  
Carlos Farias ◽  
Sheila Braga
2018 ◽  
Vol 1 (2) ◽  
pp. 70-74
Author(s):  
Rohini Sigdel ◽  
Maya Lama ◽  
Sanish Gurung ◽  
Bishal Gurung ◽  
Anil Prasad Neupane ◽  
...  

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.


2016 ◽  
Vol 6 (3) ◽  
Author(s):  
Mahshid Nikooseresht ◽  
Mohamad Ali Seif Rabiei ◽  
Pooran Hajian ◽  
Razieh Dastaran ◽  
Nasim Alipour

2019 ◽  
Vol 13 (3) ◽  
pp. 208
Author(s):  
Duane Funk ◽  
MartaJ Cenkowski ◽  
Doug Maguire ◽  
Stephen Kowalski ◽  
FahdA Al Gurashi

2020 ◽  
Vol 15 (2) ◽  
pp. 167-172
Author(s):  
Kihyug Kwon ◽  
Dohyung Kim ◽  
Hyunmin Jo ◽  
Ji Eun Park ◽  
Kyung Ok Kim

Background: Postpartum hemorrhage is the leading cause of maternal mortality. Oxytocin being the most popular uterotonic agent, has been routinely administered after both vaginal delivery and cesarean section. Carbetocin is a newer uterotonic agent and provides the benefit of a longer duration of action without additional administration post-delivery.Methods: We recruited 34 women undergoing elective cesarean section under spinal anesthesia. All patient was received spinal anesthesia using 0.5% hyperbaric Marcaine 8–10 mg in conjugation with fentanyl 20 μg in the left lateral decubitus position. Hartmann’s solution 10–15 ml/kg was administered before carbetocin. The operation started as soon as sensory block at level T4–T6 was confirmed. A non-invasive hemodynamic monitoring cuff (Finometer®) was attached to the patient’s finger soon after the induction of spinal anesthesia. Using the Finometer, we recorded the heart rate and mean arterial pressure at every 15 s, starting from 15 s before the administration of carbetocin to 5 min after. After the removal of the placenta, the bolus group was administered intravenous bolus injection of carbetocin 100 μg and the infusion group was administered carbetocin 100 μg diluted in 50 ml normal saline, over 5 min using an infusion pump.Results: The demographic data showed no significant difference between the two groups. Furthermore, there were no significant hemodynamic differences between the two groups.Conclusions: The method of administration of carbetocin does not influence its hemodynamic effects.


Author(s):  
P. Fung ◽  
G. Dumont ◽  
M. Ansermino ◽  
M. Huzmezan ◽  
A. Kamani

2020 ◽  
Vol 16 (3) ◽  
Author(s):  
Ramesh Bhattarai ◽  
Rajiv Shah ◽  
Sita Dhakal ◽  
Pragya Malla ◽  
Srijana Sapkota

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.  


2020 ◽  
Vol 15 ◽  
Author(s):  
Arash karimi ◽  
Jahanbakhsh Nejadi ◽  
Mahnaz Shamseh ◽  
Nooshin Ronasi ◽  
Mehdi Birjandi

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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