comparing the hemodynamic effects of spinal anesthesia in preeclamptic and healthy parturients during cesarean section
نویسندگان
چکیده
background despite controversies about the safest anesthetic technique for cesarean delivery in severely preeclamptic women, there is evidence that supports the use of spinal anesthesia in this group of patients. objectives this prospective randomized clinical trial was designed to determine the hemodynamic effects of low-dose spinal bupivacaine and the incidence of spinal anesthesia-associated hypotension in severely preeclamptic and healthy parturients undergoing cesarean sections. conclusions our results confirm that low-dose bupivacaine spinal anesthesia is associated with a lower risk of hypotension than previously believed, and it can therefore be safely used in severe preeclamptic women undergoing cesarean delivery. results the incidence rate of hypotension among the preeclamptic patients was lower than that of the healthy parturients, despite the former group receiving smaller volumes of intravenous fluids (p < 0.05). the total doses of iv ephedrine for treating hypotension were significantly lower among the preeclamptic patients (3.2 mg in preeclamptic patients versus 7.6 mg in normotensive patients) (p = 0.02). the one-minute apgar score was significantly lower for the preeclamptic parturients (8.4 ± 0.7 versus 7.2 ± 1.5) (p = 0.001), but there was no significant difference in the five-minute apgar scores between the two groups. patients and methods spinal anesthesia was performed with 10 mg (= 2 ml) hyperbaric 0.5% bupivacaine plus 2.5 µg sufentanil in two groups of patients after they received 500 ml of iv lactated ringer’s solution. heart rate and blood pressure were recorded before spinal anesthesia and at two minutes intervals for 15 minutes after the block, and then every five minutes until the end of the surgery. hypotension was defined as more than 25% of decline in the mean arterial blood pressure compared to the baseline in both groups (or systolic blood pressure < 100 mmhg in healthy parturients) and was treated with 5 mg iv ephedrine. the total amounts of intravenous administered fluid and the total doses of ephedrine were recorded for each patient as well.
منابع مشابه
Comparing the Hemodynamic Effects of Spinal Anesthesia in Preeclamptic and Healthy Parturients During Cesarean Section
BACKGROUND Despite controversies about the safest anesthetic technique for cesarean delivery in severely preeclamptic women, there is evidence that supports the use of spinal anesthesia in this group of patients. OBJECTIVES This prospective randomized clinical trial was designed to determine the hemodynamic effects of low-dose spinal bupivacaine and the incidence of spinal anesthesia-associat...
متن کاملMINIDOSE BUPIVACAINE – FENTANYL SPINAL ANESTHESIA FOR CESAREAN SECTION IN PREECLAMPTIC PARTURIENTS
ABSTRACT Background: Spinal anesthesia for cesarean section is associated with a high incidence of hypotension. The synergism between intrathecal opioids and local anesthetics may make it possible to achieve reliable spinal anesthesia with minimal hypotension using a minidose of local anesthetic. Methods: Forty-four preeclamptic parturients undergoing cesarean section were randomized in two gr...
متن کاملSpinal Anesthesia in Preeclamptic Parturients
In this prospective cohort study, we compared the incidence and severity of spinal anesthesia (SA) associated hypotension in preeclamptics (n=25) versus healthy parturients (n=25) undergoing cesarean delivery. After proper preloading, SA was administered with 0.75% hyperbaric bupivacaine. Blood pressure (BP) was recorded before performing SA (baseline BP), and then after SA, every 2 minutes for...
متن کاملSpinal anesthesia with minidose bupivacaine-fentanyl for cesarean section in preeclamptic parturients.
متن کامل
minidose bupivacaine – fentanyl spinal anesthesia for cesarean section in preeclamptic parturients
abstract background: spinal anesthesia for cesarean section is associated with a high incidence of hypotension. the synergism between intrathecal opioids and local anesthetics may make it possible to achieve reliable spinal anesthesia with minimal hypotension using a minidose of local anesthetic. methods: forty-four preeclamptic parturients undergoing cesarean section were randomized in two gro...
متن کاملCOMPARISON OF HEMODYNAMIC CHANGES DUE TO INTRAVENOUS OXYTOCIN INFUSION DURING GENERAL AND SPINAL ANESTHESIA IN ELECTIVE CESAREAN SECTION
Background & Aims: Postpartum hemorrhage is one of the life-threatening complications after labor and cesarean section. Its prevalence is 6 percent. Metratonia is the most common cause of this complication. Some medications can prevent it. Oxytocin is the most common uterine vasoconstrictor and is used routinely after delivery for decreasing hemorrhage. The aim of this study is to compare hemod...
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عنوان ژورنال:
anesthesiology and pain medicineجلد ۶، شماره ۳، صفحات ۰-۰
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