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Spinal anaesthesia hypotension

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https://www.readbyqxmd.com/read/29520867/randomised-double-blind-comparison-of-bolus-phenylephrine-or-ephedrine-for-treatment-of-hypotension-in-women-with-pre-eclampsia-undergoing-caesarean-section
#1
M Mohta, S Duggal, G T Chilkoti
Treatment of post-spinal hypotension during caesarean section assumes special concern in pre-eclamptic patients due to a compromised fetoplacental circulation and increased risk of placental hypoperfusion. Phenylephrine and ephedrine are the most commonly used vasopressors, although the best choice is still not clear. We studied 80 pre-eclamptic women with a singleton pregnancy who underwent caesarean section with spinal anaesthesia, and who developed hypotension defined as a decrease in systolic arterial pressure ≥ 20% from baseline or absolute value < 100 mmHg...
March 9, 2018: Anaesthesia
https://www.readbyqxmd.com/read/29416149/maternal-and-anaesthesia-related-risk-factors-and-incidence-of-spinal-anaesthesia-induced-hypotension-in-elective-caesarean-section-a-multinomial-logistic-regression
#2
Atousa Fakherpour, Haleh Ghaem, Zeinabsadat Fattahi, Samaneh Zaree
Background and Aims: Although spinal anaesthesia (SA) is nowadays the preferred anaesthesia technique for caesarean section (CS), it is associated with considerable haemodynamic effects, such as maternal hypotension. This study aimed to evaluate a wide range of variables (related to parturient and anaesthesia techniques) associated with the incidence of different degrees of SA-induced hypotension during elective CS. Methods: This prospective study was conducted on 511 mother-infant pairs, in which the mother underwent elective CS under SA...
January 2018: Indian Journal of Anaesthesia
https://www.readbyqxmd.com/read/29397116/prevention-of-arterial-hypotension-after-spinal-anaesthesia-using-vena-cava-ultrasound-to-guide-fluid-management
#3
S Ceruti, L Anselmi, B Minotti, D Franceschini, J Aguirre, A Borgeat, A Saporito
BACKGROUND: Significant hypotension is frequent after spinal anaesthesia and fluid administration as therapy is usually empirical. Inferior vena cava (IVC) ultrasound (US) is effective to assess fluid responsiveness in critical care patients. The aim of this study was to evaluate the IVCUS-guided volume optimization to prevent post-spinal hypotension. METHODS: In this prospective, randomized, cohort study, 160 patients scheduled for surgery under spinal anaesthesia were randomized into a study group (IVCUS-group), consisting of an IVCUS analysis before spinal anaesthesia with IVCUS-guided volume management and a control group (group C) with no IVCUS assessment...
January 2018: British Journal of Anaesthesia
https://www.readbyqxmd.com/read/29373334/comparison-of-double-intravenous-vasopressor-automated-system-using-nexfin-versus-manual-vasopressor-bolus-administration-for-maintenance-of-haemodynamic-stability-during-spinal-anaesthesia-for-caesarean-delivery-a-randomised-double-blind-controlled-trial
#4
Ban Leong Sng, Wei Du, Man Xin Lee, Farida Ithnin, Deepak Mathur, Wan Ling Leong, Rehena Sultana, Nian-Lin R Han, Alex Tiong Heng Sia
BACKGROUND: Hypotension is a common side effect of spinal anaesthesia during caesarean delivery and is associated with maternal and foetal adverse effects. We developed an updated double intravenous vasopressor automated (DIVA) system that administers phenylephrine or ephedrine based on continuous noninvasive haemodynamic monitoring using the Nexfin device. OBJECTIVE: The aim of our present study is to compare the performance and reliability of the DIVA system against Manual Vasopressor Bolus administration...
January 25, 2018: European Journal of Anaesthesiology
https://www.readbyqxmd.com/read/29330854/combined-spinal-epidural-vs-spinal-anaesthesia-for-caesarean-section-meta-analysis-and-trial-sequential-analysis
#5
REVIEW
M Klimek, R Rossaint, M van de Velde, M Heesen
Combined spinal-epidural and single-shot spinal anaesthesia are both used for caesarean section. It has been claimed in individual trials that combined spinal-epidural is associated with higher sensory spread and greater cardiovascular stability. We set out to gather all available evidence. We performed: a systematic literature search to identify randomised controlled trials comparing combined spinal-epidural with spinal anaesthesia for caesarean section: conventional meta-analysis; trial-sequential analysis; and assessment of trial quality using the Grading of Recommendations Assessment, Development, and Evaluation (GRADE) system...
January 13, 2018: Anaesthesia
https://www.readbyqxmd.com/read/29217858/effect-of-co-administration-of-different-doses-of-phenylephrine-with-oxytocin-on-the-prevention-of-oxytocin-induced-hypotension-in-caesarean-section-under-spinal-anaesthesia-a-randomised-comparative-study
#6
Ranjitha Gangadharaiah, Devika Rani Duggappa, Sudheesh Kannan, S B Lokesh, Karuna Harsoor, K M Sunanda, S S Nethra
Introduction: Co-administration of phenylephrine prevents oxytocin-induced hypotension during caesarean section under spinal anaesthesia (SA), but higher doses cause reflex bradycardia. This study compares the effects of co-administration of two different doses of phenylephrine on oxytocin-induced hypotension during caesarean section under SA. Methods: In this prospective, double-blind study, 90 parturients belonging to the American Society of Anesthesiologists' physical status 1 or 2, undergoing caesarean section under SA were randomised into Group A: oxytocin 3U and phenylephrine 50 μg, Group B: oxytocin 3U and phenylephrine 75 μg, Group C: oxytocin 3U and normal saline, administered intravenously over 5 min after baby extraction...
November 2017: Indian Journal of Anaesthesia
https://www.readbyqxmd.com/read/29090732/management-of-hypotension-with-vasopressors-at-caesarean-section-under-spinal-anaesthesia-have-we-found-the-holy-grail-of-obstetric-anaesthesia
#7
EDITORIAL
J P Campbell, G M Stocks
No abstract text is available yet for this article.
January 2018: Anaesthesia
https://www.readbyqxmd.com/read/29040402/is-postspinal-hypotension-a-sign-of-impaired-cardiac-performance-in-the-elderly-an-observational-mechanistic-study
#8
J Jakobsson, S H Kalman, M Lindeberg-Lindvet, E Bartha
Background: We have previously reported that stroke volume is reduced in a majority of elderly patients undergoing surgical repair of hip fracture before and after intrathecal injection of anaesthetic. We aimed to investigate these observations further in a prospective study of elderly patients undergoing elective hip or knee arthroplasty under spinal anaesthesia. Methods: Patients ≥65 yr undergoing elective arthroplasty were monitored with LiDCOplus™ preoperatively (baseline), before and continuously for 45 min after spinal anaesthesia...
December 1, 2017: British Journal of Anaesthesia
https://www.readbyqxmd.com/read/29034983/pleth-variability-index-can-predict-spinal-anaesthesia-induced-hypotension-in-patients-undergoing-caesarean-delivery
#9
S Kuwata, K Suehiro, T Juri, S Tsujimoto, A Mukai, K Tanaka, T Yamada, T Mori, K Nishikawa
BACKGROUND: Spinal anaesthesia carries a risk of hypotension. We hypothesized that pleth variability index and perfusion index would assess maternal volume status, and thus, allow identification of patients at higher risk of developing hypotension after spinal anaesthesia for caesarean delivery. METHODS: Fifty patients undergoing elective caesarean delivery were enrolled. All patients received spinal anaesthesia with 0.5% hyperbaric bupivacaine (10 mg) and fentanyl (10 mcg)...
January 2018: Acta Anaesthesiologica Scandinavica
https://www.readbyqxmd.com/read/28986931/can-point-of-care-ultrasound-predict-spinal-hypotension-during-caesarean-section-a-prospective-observational-study
#10
L Zieleskiewicz, A Noel, G Duclos, M Haddam, A Delmas, C Bechis, A Loundou, J Blanc, A Mignon, L Bouvet, S Einav, A Bourgoin, M Leone
Spinal anaesthesia for elective caesarean section is associated with maternal hypotension, secondary to alteration of sympathetic tone and hypovolemia, in up to 70% of cases. Measurement of the subaortic variation in the velocity time integral (VTI) after passive leg raising allows prediction of fluid responsiveness. Our objective, in this prospective single-centre observational study, was to assess the ability of change in VTI after 45° passive leg raising to predict hypotension after spinal anaesthesia. Ultrasound measurements were performed just before elective caesarean section...
January 2018: Anaesthesia
https://www.readbyqxmd.com/read/28976555/techniques-for-preventing-hypotension-during-spinal-anaesthesia-for-caesarean-section
#11
REVIEW
Cheryl Chooi, Julia J Cox, Richard S Lumb, Philippa Middleton, Mark Chemali, Richard S Emmett, Scott W Simmons, Allan M Cyna
BACKGROUND: Maternal hypotension is the most frequent complication of spinal anaesthesia for caesarean section. It can be associated with nausea or vomiting and may pose serious risks to the mother (unconsciousness, pulmonary aspiration) and baby (hypoxia, acidosis, neurological injury). OBJECTIVES: To assess the effects of prophylactic interventions for hypotension following spinal anaesthesia for caesarean section. SEARCH METHODS: We searched Cochrane Pregnancy and Childbirth's Trials Register (9 August 2016) and reference lists of retrieved studies...
August 4, 2017: Cochrane Database of Systematic Reviews
https://www.readbyqxmd.com/read/28974066/post-induction-hypotension-and-early-intraoperative-hypotension-associated-with-general-anaesthesia
#12
S Südfeld, S Brechnitz, J Y Wagner, P C Reese, H O Pinnschmidt, D A Reuter, B Saugel
Background: We hypothesized that different phases of intraoperative hypotension should be differentiated because of different underlying causative mechanisms. We defined post-induction hypotension (PIH; i.e. arterial hypotension occurring during the first 20 min after anaesthesia induction) and early intraoperative hypotension (eIOH; i.e. arterial hypotension during the first 30 min of surgery). Methods: In this retrospective study, we included 2037 adult patients who underwent general anaesthesia...
July 1, 2017: British Journal of Anaesthesia
https://www.readbyqxmd.com/read/28928589/laparoscopic-cholecystectomy-under-segmental-thoracic-spinal-anesthesia-a-feasible-economical-alternative
#13
Aditya Kumar Kejriwal, Shaheen Begum, Gopal Krishan, Richa Agrawal
Laparoscopic surgery is normally performed under general anesthesia, but regional techniques like thoracic epidural and lumbar spinal have been emerging and found beneficial. We performed a clinical case study of segmental thoracic spinal anaesthesia in a healthy patient. We selected an ASA grade I patient undergoing elective laparoscopic cholecystectomy and gave spinal anesthetic in T10-11 interspace using 1 ml of bupivacaine 5 mg ml-1 mixed with 0.5 ml of fentanyl 50 μg ml-1 . Other drugs were only given (systemically) to manage patient anxiety, pain, nausea, hypotension, or pruritus during or after surgery...
July 2017: Anesthesia, Essays and Researches
https://www.readbyqxmd.com/read/28893015/comparison-of-efficacy-and-safety-of-unilateral-spinal-anaesthesia-with-sequential-combined-spinal-epidural-anaesthesia-for-lower-limb-orthopaedic-surgery
#14
Jyoti Sandeep Magar, Kishori Dhaku Bawdane, Rahul Patil
INTRODUCTION: Orthopaedic anaesthesia plan requires customi-zation as per patient's need for safe outcome. Sequential Combined Spinal Epidural Anaesthesia (Sequential CSEA) and Unilateral Single Shot Spinal anaesthesia (Unilateral SA), both have advantages over conventional spinal anaesthesia that they provide longer lasting block with less hypotension. AIM: To compare safety and efficacy of unilateral spinal anaesthesia with sequential combined spinal epidural anaesthesia for lower limb orthopaedic surgery ...
July 2017: Journal of Clinical and Diagnostic Research: JCDR
https://www.readbyqxmd.com/read/28891203/effects-of-epidural-volume-extension-by-saline-injection-on-the-efficacy-and-safety-of-intrathecal-local-anaesthetics-systematic-review-with-meta-analysis-meta-regression-and-trial-sequential-analysis
#15
REVIEW
M Heesen, S Weibel, M Klimek, R Rossaint, L R Arends, P Kranke
Epidural volume extension, a modification of combined spinal-epidural anaesthesia, involves the epidural injection of saline in order to increase the spread of drugs given intrathecally. Results from individual studies have so far been contradictory and we aimed to gather the available evidence for this technique. We performed a systematic literature search for randomised, controlled trials comparing epidural volume extension after spinal injection with a control group without epidural injection in patients undergoing surgery...
November 2017: Anaesthesia
https://www.readbyqxmd.com/read/28890560/perfusion-index-as-a-predictor-of-hypotension-following-spinal-anaesthesia-in-lower-segment-caesarean-section
#16
Devika Rani Duggappa, Mps Lokesh, Aanchal Dixit, Rinita Paul, R S Raghavendra Rao, P Prabha
BACKGROUND AND AIMS: Perfusion index (PI) is a new parameter tried for predicting hypotension during spinal anaesthesia for the lower segment caesarean section (LSCS). This study aimed at investigating the correlation between baseline perfusion index and incidence of hypotension following SAB in LSCS. METHODS: In this prospective observational study, 126 parturients were divided into two groups on the basis of baseline PI. Group I included parturients with PI of ≤3...
August 2017: Indian Journal of Anaesthesia
https://www.readbyqxmd.com/read/28764270/feasibility-and-complications-of-spinal-anaesthesia-in-percutaneous-nephrolithotomy-our-experience
#17
Manoj Kamal, Pradeep Sharma, Geeta Singariya, Rajesh Jain
INTRODUCTION: Percutaneous Nephrolithotomy (PCNL) is the treatment modality used for the extraction of large renal stones, or multiple calculi or stones resistant to shock wave lithotripsy. The General Anaesthesia (GA) is the standard modality for PCNL. However, few studies conclude that Spinal Anaesthesia (SA) can be an alternative method of anaesthesia with similar incidence of complications. AIM: In our study we evaluated the feasibility of spinal anaesthesia in terms of intraoperative and postoperative results in patients undergoing PCNL...
June 2017: Journal of Clinical and Diagnostic Research: JCDR
https://www.readbyqxmd.com/read/28743315/tight-intra-operative-blood-pressure-control-versus-standard-care-for-patients-undergoing-hip-fracture-repair-hip-fracture-intervention-study-for-prevention-of-hypotension-hip-hop-trial-study-protocol-for-a-randomised-controlled-trial
#18
Iain Keith Moppett, Stuart White, Richard Griffiths, Donal Buggy
BACKGROUND: Hypotension during anaesthesia for hip fracture surgery is common. Recent data suggest that there is an association between the lowest intra-operative blood pressure and mortality, even when adjusted for co-morbidities. This is consistent with data derived from the wider surgical population, where magnitude and duration of hypotension are associated with mortality and peri-operative complications. However, there are no trial to data to support more aggressive blood pressure control...
July 25, 2017: Trials
https://www.readbyqxmd.com/read/28718233/haemodynamic-preservation-in-caesarean-sections-by-low-dose-0-5-hyperbaric-bupivacaine
#19
Maqsood Ahmad, Mumtaz Ahmad, Naveel Atif
BACKGROUND: Spinal anaesthesia is technique of choice for caesarean sections and hyperbaric bupivacaine is a recommended drug for this popular block. Although safe but few complications are haemodynamic changes, postdural puncture headache, cauda equina syndrome and radiculopathy. However, hypotension remains the common side effect which is believed to occur in 95% of patients resulting in reduction of uteroplacental perfusion causing foetal acid-base abnormalities. Various doses regimes are in safe anaesthesia practice for providing regional anaesthesia for such patients with least detrimental effects on foetal outcome...
April 2017: Journal of Ayub Medical College, Abbottabad: JAMC
https://www.readbyqxmd.com/read/28717545/low-dose-lignocaine-butorphanol-vs-low-dose-bupivacaine-for-spinal-anaesthesia-in-day-care-urological-surgeries-a-prospective-randomized-control-trial
#20
Shahil Rameshbhai Khant, Rajeev Chaudhari, Rishikesh Arun Kore, Shirish Bhagwat, Ranjan Purushottam Jakhalekar
OBJECTIVE: A local anaesthetic with fast onset, short and reliable duration of anaesthesia may be preferable for day care urological surgeries. Low dose lignocaine is believed to act faster and to have a shorter duration of action than low dose bupivacaine. Use of lignocaine for spinal anesthesia is discouraged now a days because of rare reports of transient neurological symptoms. The purpose of this study was to compare effectiveness and safety of low dose of lignocaine + butorphanol against low dose of bupivacaine for day care urological surgeries...
June 2017: Turkish Journal of Urology
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