Introduction. Spinal anesthesia is one of the oldest and most commonly used regional techniques. It based on injection a local anesthetic into subarachnoid space, during which there transient interruption impulse conduction in spinal nerve roots. Application anesthesia. The use depends following factors: site surgical procedure, type duration degree necessary relaxation, presence accompanying d...

HYPOTENSION during spinal anesthesia for cesarean delivery has been of concern since the 1960s. Along with multiple strategies aimed at treating or preventing hypotension, some investigators have attempted to identify patients more likely to have hypotension in the hopes of targeting treatment. In this issue of ANESTHESIOLOGY, Hanss et al. report that measurement of heart rate variability (HRV)...

BACKGROUND Spinal anaesthesia for caesarean section exposes to high incidence of arterial hypotension which can result in maternal and neonatal morbidity. We hypothesized that the reduction of this dose from 10 mg to 7.5 mg would minimize hypotension without altering pain relief. METHODS In this double-blind prospective study, 80 ASA1 women scheduled for elective caesarean section were random...

Two patients developed paraplegia associated with the use of the intraaortic balloon pump. In one patient, transient spinal ischemic episodes ceased after removal of the intraaortic balloon and the second patient apparently sustained spinal cord infarction. Possible etiologic mechanisms include vascular occlusion due to balloon position, arterial spasm, thromboembolic phenomena, hypotension, hy...

Spinal anaesthesia is the preferred anaesthetic technique for elective Caesarean deliveries. Hypotension is the most common side-effect and has both maternal and neonatal consequences. Different strategies have been attempted to prevent spinal-induced hypotension, including the use of low-dose bupivacaine. We conducted a systematic search for randomized controlled trials comparing the efficacy ...

UNLABELLED This quantitative systematic review compared the efficacy and safety of ephedrine with phenylephrine for the prevention and treatment of hypotension during spinal anesthesia for cesarean delivery. Seven randomized controlled trials (n = 292) were identified after a systematic search of electronic databases (MEDLINE, EMBASE, The Cochrane Controlled Trials Registry), published articles...

STANDARDS There is insufficient evidence to support treatment standards. GUIDELINES There is insufficient evidence to support treatment guidelines. OPTIONS Hypotension (systolic blood pressure <90 mmHg) should be avoided if possible or corrected as soon as possible after acute spinal cord injury. Maintenance of mean arterial blood pressure at 85 to 90 mmHg for the first 7 days after acute s...

BACKGROUND AND OBJECTIVES Published data suggest that clonidine, an alpha2-adrenergic agonist, in association with bupivacaine, may increase the incidence of intraoperative hypotension and bradycardia during high-level spinal anesthesia. This study aimed at determining the synergistic potential of two clonidine doses (45 and 75 microg) and hyperbaric bupivacaine on characteristics and hemodynam...