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Postspinal hypotension

Manohar Panneer, Prakash Murugaiyan, Sufala Viswas Rao
BACKGROUND: Dexmedetomidine and clonidine have been used for the prevention and treatment of shivering following spinal blockade. A prospective randomized, double-blinded study was conducted to compare the efficacy and safety of dexmedetomidine and clonidine in controlling postspinal shivering. METHODS: A total of sixty participants of equal sex, aged between 18 and 60 years of American Society of Anesthesiologists (ASA) I/II Class, who underwent orthopedic lower limb surgeries under spinal anesthesia with ≥Grade III shivering were randomly divided into two groups, Group D (n = 30) received injection dexmedetomidine 0...
January 2017: Anesthesia, Essays and Researches
Desire N Onwochei, Warwick D Ngan Kee, Lillia Fung, Kristi Downey, Xiang Y Ye, Jose C A Carvalho
BACKGROUND: The use of phenylephrine as the first-line agent for prevention and treatment of maternal hypotension during cesarean delivery (CD) may reduce cardiac output, posing a theoretical risk to mother and fetus. Norepinephrine has been suggested as a potential alternative, because its β-adrenergic effects might result in greater heart rate and cardiac output than phenylephrine. The use of norepinephrine to prevent and treat hypotension during CD is new, and its use as a bolus has not been fully determined in this context...
February 28, 2017: Anesthesia and Analgesia
Brendan Carvalho, Luo Luo Zheng, Alexander Butwick
No abstract text is available yet for this article.
February 2017: Anesthesia and Analgesia
Anshul Jain, Shivali Pandey, Roopesh Kumar, Chavi Sethi, Sanjya Sharma
BACKGROUND: Subarachnoid blockade for cesarean section still poses a threat of profound hypotension and can result in unstable maternal and fetal hemodynamics. The correlation of fetal breech and vertex presentation with the occurrence of hypotension under spinal anesthesia is reviewed in this retrospective, double-blind study. PATIENTS AND METHODS: The study was conducted on pregnant females scheduled for a lower segment cesarean section between January 2014 and December 2014...
2015: Local and Regional Anesthesia
Saru Singh, Trupti D Shah, Ruchi Gupta, Preetween Kaur, Chiteshwar S Walia, Saroj Sehrawat
CONTEXT: Perioperative fluid management in elderly poses considerable challenge to the anesthesiologist. The conventional crystalloid loading may not be a preferred regime in this subgroup of patients since an exaggerated hemodynamic response is expected due to blunted sympathetic response and compromised cardiorespiratory system. AIMS: This study was designed in the elderly patient for comparing efficacy, side-effects and limitations of prophylactic ephedrine 30 mg (intramuscular [i...
September 2014: Anesthesia, Essays and Researches
Valerie Zaphiratos, Dolores M McKeen, Bruce Macaulay, Ronald B George
Anterior spinal artery syndrome has rarely been reported as a cause of permanent neurologic complications after neuraxial anesthesia in obstetric patients. A parturient developed anterior spinal artery syndrome after spinal anesthesia for cesarean delivery. A healthy 32-year-old parturient presented at 41(2/7) weeks for primary elective caesarean delivery for breech presentation. Spinal anesthesia was easily performed with clear cerebrospinal fluid, and block height was T4 at 5 minutes. Intraoperative course was uneventful except for symptomatic bradycardia (37-40 beats per minute) and hypotension (88/44 mm Hg) 4 minutes postspinal anesthesia, treated with ephedrine and atropine...
February 2015: Journal of Clinical Anesthesia
Indu Sen, Rozeeta Hirachan, Neerja Bhardwaj, Kajal Jain, Vanita Suri, Praveen Kumar
BACKGROUND: Prevention of post-spinal hypotension in obstetric patients can be accomplished using intravenous fluid expansion and prophylactic use of sympathomimetic drugs. The affect of combination of colloids and phenylephrine infusion on maternal hemodynamics has not been widely studied and there is no consensus about the dosage required and time of starting its administration. MATERIALS AND METHODS: This prospective, randomized, double-blind study enrolled 90 healthy term parturients undergoing elective Cesarean delivery under lumbar subarachnoid block (0...
July 2013: Journal of Anaesthesiology, Clinical Pharmacology
Mustafa Kadihasanoglu, Ersagun Karaguzel, Cem Kivilcim Kacar, Mehmet Salih Arıkan, Mustafa Engin Yapici, Nihat Türkmen
OBJECTIVE: To determine whether local anesthesia (LA) is an acceptable alternative to spinal anesthesia (SA) for varicocelectomy. METHODS: A total of 60 men with varicocele were included in the present study. The evaluation of pain during and after surgery was determined using the visual analog scale. The secondary outcome measures of the present study were the interval to the first postoperative analgesic requirement, total analgesic consumption, and the incidence of side effects...
July 2012: Urology
Anne Doherty, Yayoi Ohashi, Kristi Downey, Jose C A Carvalho
BACKGROUND AND OBJECTIVES: Blood pressure monitoring offers a limited understanding of the hemodynamic consequences of spinal anesthesia for cesarean delivery. The purpose of this study was to assess, with the aid of a non-invasive cardiac output monitor based on bioreactance, the hemodynamic changes during elective cesarean delivery under spinal anesthesia in which intermittent boluses of phenylephrine were used to prevent and treat hypotension. METHODS: This observational study was conducted with the Research Ethics Board approval, and all participants provided written informed consent...
May 2011: Revista Brasileira de Anestesiologia
Ambrose Rukewe, Temitope Alonge, Akinola Fatiregun
BACKGROUND: Spinal anesthesia is underutilized for surgery in children in Nigeria. Until recently, only caudal and general anesthesia are employed in the pediatric age group, and the thought of spinal anesthesia was an anathema. This study evaluated cardiovascular changes, duration of spinal block, the length of surgery, length of spinal needle to establish lumbar puncture, and the incidence of complications associated with this procedure. METHODS: Thirty-two children ASA 1 and 2 between the ages of 2 and 12 had spinal block from August 1, 2008 to February 28, 2010 for orthopedic and plastic surgical procedures...
November 2010: Paediatric Anaesthesia
Shigeru Saeki, Makiko Kobayashi, Eri Miyake, Takahiro Suzuki
Crisis management during regional anesthesia including peripheral nerve block, epidural anesthesia and spinal anesthesia was reviewed. Common crisis which is encountered during regional anesthesia includes toxic reaction to local anesthetic drugs, allergic reaction induced by local anesthetic drugs, reaction induced by epinephrine, nerve injury, hematoma etc. Concerning peripheral nerve block, crisis encountered during brachial plexus block, interscalene block and supraclavicular block used for surgical operation of upper extremity was discussed...
May 2009: Masui. the Japanese Journal of Anesthesiology
Alison Macarthur, Edward T Riley
No abstract text is available yet for this article.
2007: International Anesthesiology Clinics
David W Cooper, Leo Jeyaraj, Ryan Hynd, Rebekah Thompson, Tim Meek, David M Ryall, Manmohan S Kokri
BACKGROUND: The authors have previously observed an apparent association between rostral spread of spinal anesthesia and choice of intravenous vasopressor given to maintain maternal systolic arterial pressure during cesarean delivery. This study tested the hypothesis that an intravenous infusion of phenylephrine can reduce rostral spread of spinal anesthesia in pregnancy, compared with ephedrine. METHODS: The study was randomized and double blind. It compared phenylephrine 100 microg/ml (phenylephrine group, n = 30), and ephedrine 3 mg/ml (ephedrine group, n = 30), given by infusion, to prevent maternal hypotension during combined spinal-epidural anesthesia for cesarean delivery...
July 2004: Anesthesiology
Aliye Esmaoglu, Sinan Karaoglu, Ayse Mizrak, Adem Boyaci
This prospective randomized study compared unilateral and bilateral spinal anesthesia with respect to intraoperative and postoperative complications, and time to discharge from hospital for knee arthroscopies in outpatients. We studied 70 ASA I patients scheduled for elective outpatient knee arthroscopy. The patients were randomly allocated into two groups to receive either 3 ml (15 mg) 0.5% hyperbaric bupivacaine (bilateral group) or 1.5 ml (7.5 mg) 0.5% hyperbaric bupivacaine (unilateral group). The duration of motor and sensory block and the time to discharge from the hospital were all recorded...
March 2004: Knee Surgery, Sports Traumatology, Arthroscopy: Official Journal of the ESSKA
No abstract text is available yet for this article.
September 1960: American Journal of Obstetrics and Gynecology
Aya Niijima, Nobuhisa Iriuchijima, Akihiro Tomioka, Masayuki Sasaki, Makoto Sudo, Fumio Goto
A 49-year-old man developed severe headache after spinal anesthesia. We found diffuse meningeal enhancement on gadolinium enhanced MRI and diffuse meningeal thickening on plain MRI. These MRI findings and postural headache suggest intracranial hypotension. Injection of autologous blood 10 ml into his epidural space was effective to ameliorate the headache. MRI findings were useful for the diagnosis of postspinal headache.
July 2003: Masui. the Japanese Journal of Anesthesiology
Michael A Frölich, Donald Caton
PURPOSE: Hypotension is the most frequent complication of spinal anesthesia in pregnant patients. This study was designed to identify patients at risk for postspinal hypotension based on preoperative vital signs before and after an orthostatic challenge. METHODS: Forty healthy women scheduled for elective Cesarean section were enrolled in this prospective trial. Blood pressure (BP) and heart rate (HR) were recorded with the patient in the lateral supine position and after standing up...
February 2002: Canadian Journal of Anaesthesia, Journal Canadien D'anesthésie
O Hönig, H Winter, K R Baum, P Schöder, P Winter
UNLABELLED: As a consequence of the progress in (perinatal) medicine the number of pregnant women with severe cardiopulmonal risk, who need caesarean delivery, is rising. The anaesthetic care of these patients requires optimal preparation and--as a prerequisite--constant intraoperative vital functions (heart rate, blood pressure, oxygen saturation). Typical risks like airway-problems, hypoxia, hyper- and hypotension and tachycardia must be strictly avoided. We report a case of successful caesarean delivery in a patient with severe coronary heart disease, using spinal catheter technique...
August 1998: Der Anaesthesist
W S Chan, M G Irwin, W N Tong, Y H Lam
We compared the efficacy of prophylactic ephedrine infusion over fluid preloading in prevention of maternal hypotension during spinal anaesthesia for Caesarean section. Forty-six women undergoing elective Caesarean section at term were allocated randomly to receive either intravenous fluid preloading with Hartmann's solution 20 (fluid group) or prophylactic intravenous ephedrine 0.25 (ephedrine group). Moderate hypotension was defined as > or = 20% reduction in systolic blood pressure and severe hypotension as > or = 30% reduction in systolic blood pressure...
September 1997: Anaesthesia
M Miyabe, S Sato
BACKGROUND AND OBJECTIVES: The effect of the head-down tilt position after induction of spinal anesthesia for cesarean delivery on blood pressure and level of sensory block was examined. METHODS: Patients were allocated randomly into two groups, the head-down tilt group (n = 17) and the horizontal group (n = 17). In the head-down tilt group, patients were positioned with a 10 degrees head-down tilt immediately after supine positioning, while those in the horizontal group were maintained in a horizontal position...
May 1997: Regional Anesthesia
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