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Spinal anaesthesia hypotension

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https://www.readbyqxmd.com/read/29040402/is-postspinal-hypotension-a-sign-of-impaired-cardiac-performance-in-the-elderly-an-observational-mechanistic-study
#1
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...
October 10, 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
#2
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)...
October 16, 2017: Acta Anaesthesiologica Scandinavica
https://www.readbyqxmd.com/read/28986931/can-point-of-care-ultrasound-predict-spinal-hypotension-during-caesarean-section-a-prospective-observational-study
#3
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...
October 7, 2017: Anaesthesia
https://www.readbyqxmd.com/read/28976555/techniques-for-preventing-hypotension-during-spinal-anaesthesia-for-caesarean-section
#4
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
#5
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
#6
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
#7
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
#8
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
#9
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
#10
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
#11
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
#12
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
#13
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
https://www.readbyqxmd.com/read/28653319/body-height-and-the-spread-of-spinal-anaesthesia-for-caesarean-section-a-prospective-controlled-trial
#14
Y-J She, X Zheng, B-S Zhao, M-T Zeng, Y-H Tan, X-R Song
BACKGROUND: No conclusive evidence exists on the effect of patient height on the spread of spinal anaesthesia. Our aim was to measure the ED50 and ED95 values of intrathecal ropivacaine in taller and shorter patients, and thus investigate the hypothesis that the spinal dose requirement in shorter patients is lower than that in taller patients undergoing caesarean section. METHODS: In this study, 270 pregnant women were assigned to the taller (Group T) or shorter group (Group S) based on their heights...
August 2017: Acta Anaesthesiologica Scandinavica
https://www.readbyqxmd.com/read/28571237/dexmedetomidine-as-an-additive-to-spinal-anaesthesia-in-orthopaedic-patients-undergoing-lower-limb-surgeries-a-randomized-clinical-trial-comparing-two-different-doses-of-dexmedetomidine
#15
Arati Rai, Meyong Pincho Bhutia
INTRODUCTION: Use of dexmedetomidine as an additive to spinal anaesthesia is gaining popularity; but there seems to be no clear consensus on the ideal dose to be used. Because of dose related prolongation of duration of motor blockade along with increase in the incidence of side effects of dexmedetomidine namely hypotension and bradycardia, use of higher doses is not recommended. AIM: To evaluate the efficacy of two different doses of dexmedetomidine (3 μg and 5 μg) given in combination with 0...
April 2017: Journal of Clinical and Diagnostic Research: JCDR
https://www.readbyqxmd.com/read/28553766/intravenous-dexmedetomidine-during-spinal-anaesthesia-for-caesarean-section-a-meta-analysis-of-randomized-trials
#16
Zeqing Bao, Chengmao Zhou, Xianxue Wang, Yu Zhu
Objective To evaluate the efficacy and safety of spinal anaesthesia using dexmedetomidine for caesarean section. Methods PubMed, The Cochrane Library, and CNKI were searched for relevant literature. Results The incidence of nausea and vomiting in the dexmedetomidine group was significantly lower than that in the control group (OR = 0.21, 95% CI: 0.12-0.35, P < 0.00001). No difference was found in the incidence of pruritus between the two groups (OR = 1.21, 95% CI: 0.36-4.09, P = 0.76).The dexmedetomidine group had a higher incidence of bradycardia than did the control group (OR = 2...
June 2017: Journal of International Medical Research
https://www.readbyqxmd.com/read/28494915/injection-speed-of-spinal-anaesthesia-for-caesarean-delivery-in-asian-women-and-the-incidence-of-hypotension-a-randomised-controlled-trial
#17
Chun Fai Chiang, M Shahnaz Hasan, Sin Wan Tham, Sebastian Sundaraj, Ahmad Faris, Nagappan Ganason
STUDY OBJECTIVE: The purpose of this investigation was to determine if a slower speed of spinal anaesthesia injection would reduce the incidence of hypotension. STUDY DESIGN: Randomised controlled trial. SETTING: Tertiary level hospital in Malaysia. PATIENTS: 77 patients undergoing elective Caesarean delivery. INTERVENTION: Differing speeds of spinal injection. MEASUREMENTS: Systolic blood pressure was assessed every minute for the first 10min and incidence of hypotension (reduction in blood pressure of >30% of baseline) was recorded...
June 2017: Journal of Clinical Anesthesia
https://www.readbyqxmd.com/read/28375713/comparing-spinal-blockade-effectiveness-and-maternal-hemodynamics-using-25-gauge-and-29-gauge-spinal-needles-with-the-same-volumetric-flow-rate-in-patients-undergoing-caesarean-section
#18
Taner Ciftci, Hayrettin Daskaya, Serdar Efe
Spinal needles with different diameters can be used to prevent side effects in patients undergoing spinal anaesthesia. However, the velocity of local anaesthetic changes through the spinal needle depending on the diameter of it. Local anaesthetic injection velocity has been reported to be associated with the spinal block level. We aimed to compare spinal needles of different diameters with the same local anaesthetic volumetric flow rate in terms of spinal blockade and hemodynamics in obstetric patients. Eighty-four patients received spinal anaesthesia by either a 25G needle or 29G with the same volumetric flow rate...
April 4, 2017: Journal of Obstetrics and Gynaecology: the Journal of the Institute of Obstetrics and Gynaecology
https://www.readbyqxmd.com/read/28289667/laparoscopic-cholecystectomy-under-spinal-epidural-anesthesia-vs-general-anaesthesia-a-prospective-randomised-study
#19
Turgut Donmez, Vuslat Muslu Erdem, Sinan Uzman, Dogan Yildirim, Huseyin Avaroglu, Sina Ferahman, Oguzhan Sunamak
PURPOSE: Laparoscopic cholecystectomy (LC) is usually performed under the general anesthesia (GA). Aim of the study is to investigate the availability, safety and side effects of combined spinal/epidural anesthesia (CSEA) and comparison it with GA for LC. METHODS: Forty-nine patients who have a LC plan were included into the study. The patients were randomly divided into GA (n = 25) and CSEA (n = 24) groups. Intraoperative and postoperative adverse events, postoperative pain levels were compared between groups...
March 2017: Annals of Surgical Treatment and Research
https://www.readbyqxmd.com/read/28277383/the-use-of-vasopressors-during-spinal-anaesthesia-for-caesarean-section
#20
Warwick D Ngan Kee
PURPOSE OF REVIEW: Hypotension remains one of the most researched subjects in obstetric anaesthesia. The purpose of this study is to review the most recent published articles on the use of vasopressors during spinal anaesthesia for caesarean section. RECENT FINDINGS: Despite continued research indicating advantages of phenylephrine over ephedrine, practitioners in some countries continue to favour ephedrine. Recent research has continued to compare the two drugs with some work emerging on high-risk patients...
June 2017: Current Opinion in Anaesthesiology
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