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Postspinal hypotension

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
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
Zifeng Xu, Tao Xu, Puwen Zhao, Rui Ma, Mazhong Zhang, Jijian Zheng
BACKGROUND: Aortocaval compression by the gravid uterus, low baseline vasomotor tone, and spinal anesthesia-related sympathetic blockade contribute to spinal anesthesia-induced hypotension during cesarean delivery. The finger perfusion index (PI) can predict spinal hypotension by reflecting baseline vasomotor tone, but cannot directly reflect aortocaval compression by the gravid uterus. This study aimed to examine whether baseline toe PIs predict the incidence of maternal hypotension and reflect aortocaval compression by the gravid uterus during cesarean delivery under spinal anesthesia...
November 2017: Anesthesia and Analgesia
Aparna Abhijit Bagle, Adithya Vishnu, Anil Kumar, Amit Malik, Vinit Garg, Gayatri Khanvilkar
BACKGROUND: Spinal blockade provides excellent anesthesia for patients undergoing cesarean section. However, hypotension after spinal anesthesia is a common adverse effect that is commonly experienced in patients undergoing cesarean section. The aim of our study was to analyze if a simple technique like leg wrapping with elastic crepe bandage would be effective in controlling postspinal hypotension. MATERIALS AND METHODS: Sixty full-term pregnant patients who were posted for cesarean section belonging to American Society of Anesthesiologists I and II were divided into two groups...
April 2017: Anesthesia, Essays and Researches
Khosrou Naghibi, Mojtaba Rahimi, Zahra Mashayekhi
BACKGROUND: In this randomized, double-blinded case-control study, we investigated the intravenous effects of ephedrine or phenylephrine on prevention of post-spinal hypotension in elective lower abdominal surgery under spinal anesthesia. MATERIALS AND METHODS: One hundred and thirty-five patients, American Society of Anesthesiologists physical status I or II candidate for elective lower abdominal surgery under spinal anesthesia were randomized to three groups (45 each)...
2017: Advanced Biomedical Research
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...
July 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
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