Track topics on Twitter Track topics that are important to you
Maternal hypotension occurs commonly during cesarean delivery under spinal anesthesia. We evaluated whether hypotension due to aortocaval compression could be prevented by maintaining a lateral position after an intrathecal injection.
Eighty-six women undergoing elective cesarean delivery were enrolled. Spinal anesthesia was conducted in the right lateral position using 8 mg of hyperbaric bupivacaine and 15 µg of fentanyl. Patients were randomly assigned to maintain the right lateral position for 6 min before assuming the wedged supine position (group L), or to assume the wedged supine position immediately after the spinal injection (group S). Hypotension was defined as a decrease in mean arterial pressure to <80% of baseline. Ephedrine was given if blood pressure decreased to <70% of baseline. The incidence of hypotension and nausea, ephedrine requirement, maximal block height, and neonatal outcomes were evaluated.
No significant between-group differences were observed in the lowest blood pressure, total ephedrine dose, or incidence of hypotension or nausea. Onset of hypotension was delayed (6±2 vs. 10±3 min, P<0.001), and the sensory block level was more cephalad in group L than in group S (T2 [C8-T5] vs. T4 [T1-T6], P=0.001). Apgar scores did not differ between the groups.
During spinal anesthesia for elective cesarean delivery, maintaining the lateral position for 6 min after an intrathecal injection of hyperbaric bupivacaine resulted in a more gradual and higher cephalad sensory block, without an increase in the incidence of maternal hypotension.
Department of Anesthesiology and Pain Medicine, Seoul National University Bundang Hospital, Seongnam, South Korea - firstname.lastname@example.org.
This article was published in the following journal.
Name: Minerva anestesiologica
Maternal position during induction of combined spinal-epidural anesthesia (CSEA) may affect hemodynamics and block characteristics. This study aimed to assess whether the sitting position is more like...
Current recommendations for women undergoing cesarean delivery include 15° left tilt for uterine displacement to prevent aortocaval compression, although this degree of tilt is practically never achi...
Phenylephrine infusions are considered as standard management for obstetric spinal hypotension, but there remains reluctance to implement them in resource-limited contexts. This prospective, alternati...
The objective of this meta-analysis was to determine the efficacy of glycopyrrolate at reducing spinal hypotension during cesarean delivery.
Hypotension and bradycardia are known side effects of spinal anesthesia in pregnant women undergoing cesarean section and adults undergoing other surgical procedures. Whether children experience simil...
Hypotension is the most common complications after spinal anesthesia especially in pregnant patients who undergoing cesarean section. Position during spinal anesthesia may be altering the ...
Multiple studies have compared spinal anesthetic performed supine versus lateral, with varying results, in parturients having elective cesarean section. Needle positioning during spinal pl...
Maternal hypotension is a common problem during cesarian section under spinal anesthesia. The possible explanation for this is combined aortocaval compression by gravid uterus in parturien...
In this study, we will investigate the effect of left lateral tiling performed after spinal block on maternal hemodynamics compared to ordinary supine position
The quality of induction with sevoflurane, along with its ability to generate optimal conditions for Laryngeal Mask Airway (LMA) insertion without supplemental opioids or muscle relaxants,...
An intravenous anesthetic that has been used for rapid induction of anesthesia and for maintenance of anesthesia of short duration. (From Martindale, The Extra Pharmacopoeia, 30th ed, p918)
A barbiturate that is administered intravenously for the production of complete anesthesia of short duration, for the induction of general anesthesia, or for inducing a hypnotic state. (From Martindale, The Extra Pharmacopoeia, 30th ed, p919)
Reduced blood flow to the spinal cord which is supplied by the anterior spinal artery and the paired posterior spinal arteries. This condition may be associated with ARTERIOSCLEROSIS, trauma, emboli, diseases of the aorta, and other disorders. Prolonged ischemia may lead to INFARCTION of spinal cord tissue.
Delivery of an infant through the vagina in a female who has had a prior cesarean section.
Extraction of the fetus by abdominal hysterotomy anytime following a previous cesarean.
An anesthesiologist (US English) or anaesthetist (British English) is a physician trained in anesthesia and perioperative medicine. Anesthesiologists are physicians who provide medical care to patients in a wide variety of (usually acute) situations. ...
Anesthesia is the loss of feeling or sensation in all or part of the body. It may result from damage to nerves or can be induced by an anesthetist (a medical professional) using anesthetics such as thiopental or propofol or sevoflurane during a surgical ...
Women's Health - key topics include breast cancer, pregnancy, menopause, stroke Follow and track Women's Health News on BioPortfolio: Women's Health News RSS Women'...