keyword
https://read.qxmd.com/read/38476203/randomized-double-blinded-comparison-of-intermittent-boluses-phenylephrine-and-norepinephrine-for-the-treatment-of-postspinal-hypotension-in-patients-with-severe-pre-eclampsia-during-cesarean-section
#1
RANDOMIZED CONTROLLED TRIAL
Zheng-Bin Pan, Zhi-Min Sheng, Miao Zhu, Zhong Mei, Yan-Ping Shen, Jin-Ping Liu, Xiao-Wei Qian
BACKGROUND: Norepinephrine has fewer negative effects on heart rate (HR) and cardiac output (CO) for treating postspinal hypotension (PSH) compared with phenylephrine during cesarean section. However, it remains unclear whether fetuses from patients with severe pre-eclampsia could benefit from the superiority of CO. The objective of this study was to compare the safety and efficacy of intermittent intravenous boluses of phenylephrine and norepinephrine used in equipotent doses for treating postspinal hypotension in patients with severe pre-eclampsia during cesarean section...
2024: Drug Design, Development and Therapy
https://read.qxmd.com/read/38321827/point-of-care-ultrasound-in-critical-care-obstetrics-a-scoping-review-of-the-current-evidence
#2
JOURNAL ARTICLE
Juliana G Martins, Jerri Waller, Rebecca Horgan, Tetsuya Kawakita, Camille Kanaan, Alfred Abuhamad, George Saade
OBJECTIVES: To synthesize the current evidence of maternal point-of-care ultrasound (POCUS) in obstetrics. A scoping review was conducted using PubMed, Clinicaltrials.gov, and the Cochrane library from inception through October 2023. METHODS: Studies were eligible for inclusion if they described the use of POCUS among obstetric or postpartum patients. Two authors independently screened all abstracts. Quantitative, qualitative, and mixed-methods studies were eligible for inclusion...
February 6, 2024: Journal of Ultrasound in Medicine: Official Journal of the American Institute of Ultrasound in Medicine
https://read.qxmd.com/read/38313716/intracranial-hypotension-with-subdural-hematoma-after-spinal-anesthesia-in-obstetric-patient-a-rare-but-fatal-complication
#3
Sujit J Kshirsagar, Anandkumar H Pande, Sanyogita V Naik, Neha M Kamble
Intracranial bleed in the form of subdural hematoma (SDH) with intracranial hypotension after spinal anesthesia for cesarean section is a rare condition with an incidence of around 1 in 5,00,000 obstetric populations. As its presentation is similar to post-dural puncture headache (PDPH), it can be misdiagnosed sometimes. Persistent headache for more than 5 days, vomiting, blurring of vision, and convulsion can guide the diagnosis of intracranial bleed. Magnetic resonance imaging (MRI) helps to diagnose the location, size, and other abnormalities of bleed in such patients...
2024: Saudi Journal of Anaesthesia
https://read.qxmd.com/read/38313707/the-diagnostic-accuracy-of-preoperative-perfusion-index-as-a-predictor-of-postspinal-anesthesia-hypotension-in-parturients-undergoing-cesarean-delivery-a-prospective-non-blinded-observational-study
#4
JOURNAL ARTICLE
Manu P Kesavankutty, Chinmaya Panda, Habib M R Karim, Subrata Singha, Sarita Agrawal
BACKGROUND AND OBJECTIVES: Spinal anesthesia is the technique of choice for elective cesarean section with a prominent side effect of postspinal anesthesia hypotension (PSH). This needs an early prediction to avoid feto-maternal complication. This study aimed to assess the diagnostic accuracy of perfusion index (PI) and inferior vena cava collapsibility index (IVCCI) in the prediction of PSH. MATERIAL AND METHODS: Thirty parturients of American Society of Anesthesiologists Physical Status (ASA-PS) 1 and two undergoing cesarean delivery participated in the study...
2024: Saudi Journal of Anaesthesia
https://read.qxmd.com/read/38264276/comparison-of-two-norepinephrine-rescue-bolus-doses-for-management-of-severe-post-spinal-hypotension-during-elective-caesarean-delivery-a-randomized-controlled-trial
#5
Sarah M Amin, Ahmed Hasanin, Nashwa Talaat Ghanem, Maha Mostafa, Nashwa Elzayat, Mona Elsherbiny, Yaser Abdelwahab
BACKGROUND: Post-spinal hypotension is associated with maternal and neonatal complications; therefore, prompt control maternal blood pressure is necessary. In this study, we aimed to compare the efficacy and safety of two norepinephrine bolus doses in the rescue management of severe maternal hypotension during elective Cesarean delivery. METHODS: We included full-term pregnant women scheduled for Cesarean delivery under spinal anesthesia. Patients were randomized to receive either 5-mcg norepinephrine (n=79) or 10-mcg norepinephrine (n=79) for treatment of severe postspinal hypotension (systolic blood pressure ≤60% of baseline reading)...
2024: International Journal of General Medicine
https://read.qxmd.com/read/38202092/the-use-of-end-tidal-co-2-and-integrated-pulmonary-index-to-predict-postspinal-hypotension-in-cesarean-section
#6
JOURNAL ARTICLE
Emine Aslanlar, Camille Kamel Alharach, İnci Kara, Ozkan Onal, Durmuş Ali Aslanlar
Early diagnosis and treatment of postspinal hypotension (PSH) in obstetric anaesthesia reduces the risk of maternofetal complications. In this study, the effect of EtCO2 and the integrated pulmonary index (IPI) in predicting PSH was investigated. Patients scheduled for cesarean section under spinal anaesthesia were included. The Capnostream 35 respiratory monitor (Medtronic, Inc., Dublin, Ireland) was used for EtCO2 and IPI. PSH developed in 52 (63.4%) of the 82 patients. EtCO2 and IPI values decreased significantly compared with baseline values in patients who developed PSH...
December 23, 2023: Journal of Clinical Medicine
https://read.qxmd.com/read/38164096/a-comparison-of-the-effect-of-phenylephrine-and-norepinephrine-on-uteroplacental-vascular-resistance-during-the-treatment-of-postspinal-hypotension-in-preeclamptic-patients-a-randomised-controlled-study
#7
RANDOMIZED CONTROLLED TRIAL
Feng Fu, Mei-Juan Yang, Li-Li Xu, Xin-Zhong Chen
No abstract text is available yet for this article.
February 1, 2024: European Journal of Anaesthesiology
https://read.qxmd.com/read/37812381/prophylactic-norepinephrine-combined-with-6-hydroxyethyl-starch-130-0-4-co-load-infusion-for-preventing-postspinal-anesthesia-hypotension-during-cesarean-section-a-randomized-controlled-dose-finding-trial
#8
JOURNAL ARTICLE
Lei Guo, Xiangsheng Xiong, Rui Qin, Zhenzhou Li, Yongqiang Shi, Wei Xue, Ling He, Shuqin Ma, Yi Chen
PURPOSE: Colloid and/or co-load may be more effective than crystalloid for preventing postspinal anesthesia hypotension. We tested five different prophylactic norepinephrine dosages combined with colloid co-load infusion in patients receiving cesarean section and spinal anesthesia. METHODS: Patients were randomly allocated to receive different prophylactic norepinephrine dosages (0 [NE 0 group], 0.025 [NE 25 group], 0.05 [NE 50 group], 0.075 [NE 75 group], or 0...
October 9, 2023: Daru: Journal of Faculty of Pharmacy, Tehran University of Medical Sciences
https://read.qxmd.com/read/37455439/comparison-of-prophylactic-infusion-of-phenylephrine-versus-norepinephrine-for-the-prevention-of-post-spinal-hypotension-in-parturients-undergoing-elective-caesarean-section-a-randomized-double-blinded-non-inferiority-trial
#9
JOURNAL ARTICLE
Banupriya Ravichandrane, Rajeshwari Subramaniam, Thilaka Muthiah, Praveen Talawar, Rajasekar Ramadurai
OBJECTIVE: Postspinal hypotension occurs in nearly 50% of women undergoing cesarean section (CS). Although phenylephrine (PE) is currently the vasopressor of choice, severe maternal bradycardia may adversely affect the fetal status due to the reduction in the maternal cardiac output. Norepinephrine (NE) is not associated with bradycardia and is now being evaluated for the treatment of post-spinal hypotension in obstetric patients. The hypothesis of this study was that the prophylactic NE infusion was non-inferior to PE infusion when used for the prevention of postspinal hypotension...
June 16, 2023: Turkish Journal of Anaesthesiology and Reanimation
https://read.qxmd.com/read/37249928/prophylactic-norepinephrine-and-phenylephrine-boluses-to-prevent-postspinal-anesthesia-hypotension-during-cesarean-section-a-randomized-sequential-allocation-dose-finding-study
#10
RANDOMIZED CONTROLLED TRIAL
Lei Guo, Xiangzhao Xu, Rui Qin, Yongqiang Shi, Wei Xue, Ling He, Shuqin Ma, Yi Chen
BACKGROUND: Norepinephrine and phenylephrine are widely used for obstetric anesthesia. Our central objective was to determine the ED (effective dose) 90 and potency ratio of prophylactic norepinephrine and phenylephrine boluses for preventing postspinal anesthesia hypotension during cesarean section. METHODS: Patients scheduled for elective cesarean section (n = 80) were randomly allocated to receive prophylactic norepinephrine (NE) or phenylephrine (PE) boluses immediately after induction of spinal anesthesia...
2023: Drug Design, Development and Therapy
https://read.qxmd.com/read/36866963/incidence-of-bradycardia-during-noradrenaline-or-phenylephrine-bolus-treatment-of-postspinal-hypotension-in-cesarean-delivery-a-randomized-double-blinded-controlled-trial
#11
RANDOMIZED CONTROLLED TRIAL
Daniel Vieira de Queiroz, Luis Guillermo Coca Velarde, Rodrigo Leal Alves, Nubia Verçosa, Ismar Lima Cavalcanti
The treatment of choice for spinal anesthesia-induced hypotension during cesarean section is phenylephrine. As this vasopressor can cause reflex bradycardia, noradrenaline is a suggested alternative. This randomized double-blinded controlled trial included 76 parturients undergoing elective cesarean delivery under spinal anesthesia. Women received noradrenaline in bolus doses of 5 mcg or phenylephrine in bolus doses of 100 mcg. These drugs were used intermittently and therapeutically to maintain systolic blood pressure ≥ 90% of its baseline value...
July 2023: Acta Anaesthesiologica Scandinavica
https://read.qxmd.com/read/36225250/effectiveness-of-prophylactic-bolus-ephedrine-versus-norepinephrine-for-management-of-postspinal-hypotension-during-elective-caesarean-section-in-resource-limited-setting-a-prospective-cohort-study
#12
JOURNAL ARTICLE
Mitiku Desalegn, Tewoderos Shitemaw, Habtamu Tamrat
BACKGROUND: Spinal anaesthesia for caesarean section is the preferred technique since it provides better maternal safety and neonatal outcome compared to general anaesthesia. Hypotension is the most common complication after spinal anaesthesia. The study aims to determine the effectiveness of a prophylactic bolus dose of norepinephrine and ephedrine on the management of postspinal hypotension during caesarean section. METHOD: An institutional-based prospective cohort study was conducted on 84 pregnant women undergoing elective caesarean section...
2022: Anesthesiology Research and Practice
https://read.qxmd.com/read/35789051/tension-free-inguinal-hernia-repair-with-transversus-abdominis-plane-tap-block-in-elderly-high-risk-patients
#13
JOURNAL ARTICLE
Halit Batuhan Demir, Alev Atalay, Can Uc, Özgür Fırat, Sinan Ersin
BACKGROUND: Inguinal hernia repair is still being studied today because it is one of the most commonly performed surgical procedures in the world and is used in people of all ages. Although many centers use spinal anesthetic to treat inguinal hernias, complications such as hypotension from peripheral vasodilation, delayed mobilization from paralysis, urine retention and post-spinal headache might occur. Regional blocks are a significant component of multimodal anaesthesia that promotes postoperative recovery...
October 2022: ANZ Journal of Surgery
https://read.qxmd.com/read/35320967/to-study-the-role-of-perfusion-index-as-a-predictor-of-hypotension-during-spinal-anesthesia-in-lower-segment-cesarean-section-a-prospective-observational-study
#14
JOURNAL ARTICLE
Reehana Jabarulla, D Dhivya, M S Prasanth Kumar
Background and Aims: Spinal anesthesia has become the choice of neuraxial anesthesia for cesarean delivery. Hypotension, the most common side effect of spinal anesthesia is more in parturients. Perfusion index (PI) is one of the newest methods, used noninvasively for the prediction of hypotension postspinal anesthesia, evaluation of regional block success, and a tool for pain assessment. In our study, we have used PI for predicting the occurrence of hypotension postsubarachnoid block in elective lower segment cesarean section (LSCS)...
July 2021: Anesthesia, Essays and Researches
https://read.qxmd.com/read/35310422/a-randomized-controlled-trial-for-prevention-of-postspinal-anesthesia-shivering-in-gynecological-surgeries-mirtazapine-vs-dexamethasone
#15
JOURNAL ARTICLE
Ibrahim M Esmat, Ahmed M Elsayed, Hazem M El-Hariri, Tarek M Ashoor
Background: The frequency of shivering regarding regional anesthesia is 55%. Newer effective and tolerable options for postspinal anesthesia shivering (PSAS) prophylaxis are necessary to improve patients' quality of care. This research assessed the impact of preemptive mirtazapine versus preemptive dexamethasone to decrease frequency and severity of PSAS in gynecological procedures. Methods: 300 patients booked for gynecological procedures under spinal anesthesia (SA) were randomly apportioned into three groups (100 each) to get one preemptive dose of 30 mg mirtazapine tablet (M group), 8 mg dexamethasone diluted in 100 ml of saline infusion (D group) or placebo (C group) two hours before surgery...
2022: Anesthesiology Research and Practice
https://read.qxmd.com/read/34998371/norepinephrine-versus-phenylephrine-infusion-for-preventing-postspinal-hypotension-during-cesarean-section-for-twin-pregnancy-a-double-blinded-randomized-controlled-clinical-trial
#16
RANDOMIZED CONTROLLED TRIAL
Zijun Chen, Jieshu Zhou, Li Wan, Han Huang
BACKGROUND: Compared with singleton pregnancy, twin gestation is featured by a greater increase in cardiac output. Therefore, norepinephrine might be more suitable than phenylephrine for maintaining blood pressure during cesarean section for twins, as phenylephrine causes reflex bradycardia and a resultant decrease in cardiac output. This study was to determine whether norepinephrine was superior to phenylephrine in maintaining maternal hemodynamics during cesarean section for twins. METHODS: Informed consent was obtained from all the patients before enrollment...
January 8, 2022: BMC Anesthesiology
https://read.qxmd.com/read/34524157/a-randomised-double-blind-comparison-of-phenylephrine-and-norepinephrine-for-the-management-of-postspinal-hypotension-in-pre-eclamptic-patients-undergoing-caesarean-section
#17
RANDOMIZED CONTROLLED TRIAL
Medha Mohta, Lakshmi R, Geetanjali T Chilkoti, Rachna Agarwal, Rajeev Kumar Malhotra
BACKGROUND: Studies comparing phenylephrine and norepinephrine for the treatment of postspinal hypotension in pre-eclamptic patients are limited. OBJECTIVE: To compare bolus doses of phenylephrine and norepinephrine for treating hypotension in pre-eclamptic mothers undergoing caesarean section under spinal anaesthesia. It was hypothesised that norepinephrine and phenylephrine use would be associated with similar neonatal outcome. DESIGN: Randomised controlled study...
October 1, 2021: European Journal of Anaesthesiology
https://read.qxmd.com/read/33855080/implications-of-continuous-noninvasive-finger-cuff-arterial-pressure-device-use-during-cesarean-delivery-for-goal-directed-fluid-therapy-preload-optimization-a-randomized-controlled-trial
#18
JOURNAL ARTICLE
Shan-Han Yang, Yi-Shiuan Lin, Chien-Nan Lee, Ya-Jung Cheng, Ying-Hsi Chen, Hsin-Chan Chiu, Chun-Yu Wu
Background: Although fixed-volume conventional fluid preloading protocol fails to attenuate postspinal hypotension during cesarean delivery, the effect of goal-directed fluid therapy (GDFT) remains less explored. Continuous noninvasive finger cuff arterial pressure monitoring using devices such as the ClearSight System can provide the noninvasive stroke volume value, enabling clinicians to perform GDFT before spinal anesthesia; however, the efficacy of GDFT requires further elucidation...
2021: BioMed Research International
https://read.qxmd.com/read/33583066/prophylactic-norepinephrine-infusion-for-postspinal-anesthesia-hypotension-in-patients-undergoing-cesarean-section-a-randomized-controlled-dose-finding-trial
#19
RANDOMIZED CONTROLLED TRIAL
Yi Chen, Lili Zou, Zhenzhou Li, Lei Guo, Wei Xue, Ling He, Shuqin Ma, Xinli Ni
STUDY OBJECTIVE: Prophylactic norepinephrine infusion effectively lowers the incidence of postspinal anesthesia hypotension. The optimal prophylactic dose of norepinephrine remains undefined. The purpose of this study was to investigate the optimal prophylactic dose of norepinephrine to prevent postspinal anesthesia hypotension in patients undergoing cesarean section. DESIGN: Prospective, double-blind, randomized, controlled, dose-finding trial. SETTING: Operating room from March 2020 to June 2020...
April 2021: Pharmacotherapy
https://read.qxmd.com/read/33430772/dexamethasone-blunts-postspinal-hypotension-in-geriatric-patients-undergoing-orthopedic-surgery-a-double-blind-placebo-controlled-study
#20
RANDOMIZED CONTROLLED TRIAL
Tarek M Ashoor, Noha S Hussien, Sherif G Anis, Ibrahim M Esmat
BACKGROUND: Post-spinal anesthesia (PSA) hypotension in elderly patients is challenging. Correction of PSA hypotension by fluids either colloids or crystalloids or by vasoconstrictors pose the risk of volume overload or compromising cardiac conditions. Dexamethasone is used to treat conditions manifested by decrease of peripheral vascular resistance. The research team was the first to test the hypothesis of its role in preventing or decreasing the incidence of PSA hypotension. METHODS: One hundred ten patients, aged 60 years or more were recruited to receive a single preoperative dose of dexamethasone 8 mg IVI in 100 ml normal saline (D group) (55 patients) 2 h preoperatively, and 55 patients were given placebo (C group) in a randomized, double-blind trial...
January 11, 2021: BMC Anesthesiology
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