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Cesarean; hypotension

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https://www.readbyqxmd.com/read/29095263/ed50-of-intrathecal-ropivacaine-for-cesarean-section-under-prophylactic-infusion-of-phenylephrine-a-consort-study
#1
Wangping Zhang, Hanbin Wu
BACKGROUND: Studies have reported that prophylactic continuous infusion of phenylephrine during spinal anesthesia for cesarean section can decrease the spread of local anesthetics. We investigated the ED50 of intrathecal hyperbaric ropivacaine in parturient women undergoing cesarean section under prophylactic infusion of phenylephrine. METHODS: Sixty parturient women were allocated into 2 groups in this prospective study. Group P received 0.5 mL kg h of phenylephrine (5 mg/50 mL) at the start of intrathecal injection, and Group C (control group) received the same volume of saline...
November 2017: Medicine (Baltimore)
https://www.readbyqxmd.com/read/29077615/the-effect-of-adding-subarachnoid-epinephrine-to-hyperbaric-bupivacaine-and-morphine-for-repeat-cesarean-delivery-a-double-blind-prospective-randomized-control-trial
#2
Daniel Katz, Joshua Hamburger, David Gutman, Ryan Wang, Hung-Mo Lin, Michael Marotta, Jeffrey Zahn, Yaakov Beilin
BACKGROUND: Spinal anesthesia has become the most common type of anesthetic for cesarean delivery. The major limitation to spinal anesthesia is that the duration of the anesthetic may not be adequate in the event of a prolonged surgery. Some practitioners add epinephrine to hyperbaric bupivacaine to increase the duration, although its effect has not been fully studied. We therefore aimed to evaluate whether adding epinephrine to the spinal medication prolongs the duration of action of the resultant block in women presenting for repeat cesarean delivery...
October 26, 2017: Anesthesia and Analgesia
https://www.readbyqxmd.com/read/29073508/lower-limbs-venous-compression-reduces-the-incidence-of-maternal-hypotension-following-epidural-analgesia-during-term-labor
#3
Violaine Peyronnet, Arnaud Roses, Aude Girault, Marie Pierre Bonnet, Francois Goffinet, Vassilis Tsatsaris, Edouard Lecarpentier
OBJECTIVE(S): Every year in France, 10% to 20% of the 600 000 women given epidural analgesia during labor experience hypotension, which in 15% of cases is associated with fetal heart rate abnormalities. The efficiency of lower limbs venous compression in preventing the occurrence of maternal hypotension after neuraxial anesthesia has already been demonstrated, but only in the context of scheduled cesarean section. We assessed the preventive effect of medical lower limbs venous compression on the incidence of maternal hypotension after epidural analgesia during spontaneous term labor...
October 16, 2017: European Journal of Obstetrics, Gynecology, and Reproductive Biology
https://www.readbyqxmd.com/read/29033720/reducing-by-50-the-incidence-of-maternal-hypotension-during-elective-caesarean-delivery-under-spinal-anesthesia-effect-of-prophylactic-ondansetron-and-or-continuous-infusion-of-phenylephrine-a-double-blind-randomized-placebo-controlled-trial
#4
Jose Ramon Ortiz-Gómez, Francisco Javier Palacio-Abizanda, Francisco Morillas-Ramirez, Inocencia Fornet-Ruiz, Ana Lorenzo-Jiménez, Maria Lourdes Bermejo-Albares
BACKGROUND: Prophylactic administrations of ondansetron or phenylephrine have been reported to provide a protective effect against hypotension in women undergoing cesarean delivery under spinal anesthesia (SA). The main hypothesis is that ondansetron improves the hemodynamic response, especially combined with phenylephrine infusion. METHODS: This prospective, double-blind, randomized, placebo-controlled study included 265 healthy pregnant women scheduled for elective cesarean delivery under SA...
October 2017: Saudi Journal of Anaesthesia
https://www.readbyqxmd.com/read/28993164/pre-emptive-ketorolac-for-prevention-of-intraoperative-shoulder-pain-in-patients-undergoing-cesarean-section-a-double-blind-randomized-clinical-trial
#5
Mostafa Samy Abbas, Omnia Ahmed Askar, Ahmed Ali Abdel Aleem
BACKGROUND: Shoulder pain is a commonly observed but mostly neglected consequence of cesarean section and little is known as well as explored about intraoperative shoulder pain. We conducted this randomized prospective double-blinded study to evaluate the efficacy of ketorolac in reducing the incidence and severity of intraoperative shoulder pain in patients undergoing cesarean section. METHODS: Two hundred ASA I and II patients scheduled to undergo elective cesarean section under spinal anesthesia were randomized to receive either intravenous ketorolac 30 mg (ketorolac group) or normal saline (control group)...
September 20, 2017: Asian J Anesthesiol
https://www.readbyqxmd.com/read/28989908/the-effects-of-hydroxyethyl-starch-6-and-crystalloid-on-volume-preloading-changes-following-spinal-anesthesia
#6
Masoud Saghafinia, Alireza Jalali, Mahnaz Eskandari, Nahid Eskandari, Marzieh Lak
BACKGROUND: Hypotension is one of the most common complications after spinal anesthesia for cesarean delivery. Normally, preloading with fluids, especially crystalloids, is used to prevention of hypotension. METHODS: In the present randomized clinical trial study, 120 parturients presenting for elective cesarean section with the American Society of Anesthesiologists Class I and II received either 15 cc normal saline or 7 cc/kg hydroxyethyl starch 6% (Voluven) fluid...
2017: Advanced Biomedical Research
https://www.readbyqxmd.com/read/28953494/the-effect-of-prophylactic-phenylephrine-and-ephedrine-infusions-on-umbilical-artery-blood-ph-in-women-with-preeclampsia-undergoing-cesarean-delivery-with-spinal-anesthesia-a-randomized-double-blind-trial
#7
Nicole Higgins, Paul C Fitzgerald, Dominique van Dyk, Robert A Dyer, Natalie Rodriguez, Robert J McCarthy, Cynthia A Wong
BACKGROUND: Spinal anesthesia for cesarean delivery is associated with a high incidence of hypotension. Phenylephrine results in higher umbilical artery pH than ephedrine when used to prevent or treat hypotension in healthy women. We hypothesized that phenylephrine compared to ephedrine would result in higher umbilical artery pH in women with preeclampsia undergoing cesarean delivery with spinal anesthesia. METHODS: This study was a randomized double-blind clinical trial...
September 25, 2017: Anesthesia and Analgesia
https://www.readbyqxmd.com/read/28920051/comparison-of-1-and-2-minute-sitting-positions-versus-immediately-lying-down-on-hemodynamic-variables-after-spinal-anesthesia-with-hyperbaric-bupivacaine-in-elective-cesarean-section
#8
Pooran Hajian, Mahshid Nikooseresht, Tayebe Lotfi
BACKGROUND: Hypotension is one of the most common complications of spinal anesthesia in parturients undergoing cesarean section. In this regard, the patient's position may affect the incidence of hypotension. OBJECTIVES: In this clinical trial, we evaluated the effects of 1- and 2-minute sitting positions versus immediately lying down after spinal anesthesia on hypotension and vasopressor requirements. METHODS: A total of 72 parturients, scheduled for cesarean section under spinal anesthesia, were randomly divided into 3 groups (24 subjects per group)...
April 2017: Anesthesiology and Pain Medicine
https://www.readbyqxmd.com/read/28872480/a-random-allocation-graded-dose-response-study-of-norepinephrine-and-phenylephrine-for-treating-hypotension-during-spinal-anesthesia-for-cesarean-delivery
#9
Warwick D Ngan Kee
BACKGROUND: Norepinephrine has been investigated as a potential alterative to phenylephrine for maintaining blood pressure during spinal anesthesia for cesarean delivery with the advantage of less depression of maternal heart rate and cardiac output. However, the relative potencies of these two vasopressors have not been fully determined in this context. METHODS: In a random-allocation, graded dose-response study, 180 healthy patients undergoing spinal anesthesia for elective cesarean delivery received a single bolus of norepinephrine in one of six different doses ranging from 4 to 12 µg or phenylephrine in one of six different doses ranging from 60 to 200 µg to treat the first episode of hypotension...
December 2017: Anesthesiology
https://www.readbyqxmd.com/read/28860857/preventing-nausea-and-vomiting-in-women-undergoing-regional-anesthesia-for-cesarean-section-challenges-and-solutions
#10
REVIEW
Yvonne Jelting, Christian Klein, Thomas Harlander, Leopold Eberhart, Norbert Roewer, Peter Kranke
BACKGROUND: Intraoperative nausea and vomiting (IONV) or postoperative nausea and vomiting (PONV) affecting women undergoing regional anesthesia for cesarean section is an important clinical problem since these techniques are used widely. There are burdens of literature about IONV/PONV and several in parturient and cesarean. However, it needs more attention. The underlying mechanisms of IONV and PONV in the obstetrical setting mainly include hypotension due to sympathicolysis during neuraxial anesthesia, bradycardia owing to an increased vagal tone, the visceral stimulation via the surgical procedure and intravenously administered opioids...
2017: Local and Regional Anesthesia
https://www.readbyqxmd.com/read/28856920/efficacy-of-ondansetron-for-spinal-anesthesia-during-cesarean-section-a-meta-analysis-of-randomized-trials
#11
Chengmao Zhou, Yu Zhu, Zeqing Bao, Xianxue Wang, Qili Liu
Objective To investigate the efficacy and safety of ondansetron during cesarean section under spinal anesthesia. Methods We sought randomized controlled trials (RCTs) on ondansetron during spinal anesthesia for cesarean section in The Cochrane Library, PubMed, MEDLINE, and Web of Science from their inception to September 2016. Results Altogether, 21 RCTs were included in this study. Meta-analysis showed that the ondansetron group had a lower incidence of nausea/vomiting and bradycardia than the placebo group during cesarean section under spinal anesthesia [relative risk (RR) = 0...
January 1, 2017: Journal of International Medical Research
https://www.readbyqxmd.com/read/28797894/neuraxial-magnesium-sulfate-improves-postoperative-analgesia-in-cesarean-section-delivery-women-a-meta-analysis-of-randomized-controlled-trials
#12
Shih-Ching Wang, Po-Ting Pan, Hsiao-Yean Chiu, Chun-Jen Huang
BACKGROUND: We conducted this meta-analysis to elucidate whether additional neuraxial magnesium sulfate (MgSO4) can improve postoperative analgesia in women undergoing Cesarean section (CS) delivery. METHOD: We searched Pubmed, Embase and ClinicalTrial.gov. We included only randomized controlled trials that have compared the quality of postoperative analgesia with and without additional neuraxial MgSO4 in women undergoing CS delivery with neuraxial anesthesia regimens...
July 29, 2017: Asian J Anesthesiol
https://www.readbyqxmd.com/read/28795968/differential-roles-of-the-right-and-left-toe-perfusion-index-in-predicting-the-incidence-of-postspinal-hypotension-during-cesarean-delivery
#13
COMPARATIVE STUDY
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
https://www.readbyqxmd.com/read/28794836/comparing-epidural-surgical-anesthesia-and-spinal-anesthesia-following-epidural-labor-analgesia-for-intrapartum-cesarean-section-a-prospective-randomized-controlled-trial
#14
Hea-Jo Yoon, Sang-Hwan Do, Yeo Jin Yun
BACKGROUND: The conversion of epidural labor analgesia (ELA) to epidural surgical anesthesia (ESA) for intrapartum cesarean section (CS) often fails, resulting in intraoperative pain. Spinal anesthesia (SA) can provide a denser sensory block than ESA. The purpose of this prospective, non-blinded, parallel-arm, randomized trial was to compare the rate of pain-free surgery between ESA and SA following ELA for intrapartum CS. METHODS: Both groups received continuous epidural infusions for labor pain at a rate of 10 ml/h...
August 2017: Korean Journal of Anesthesiology
https://www.readbyqxmd.com/read/28741272/an-up-down-determination-of-the-required-seated-duration-after-intrathecal-injection-of-bupivacaine-and-fentanyl-for-the-prevention-of-hypotension-during-cesarean-delivery
#15
Albert Moore, Eva El-Mouallem, Aly El-Bahrawy, Ian Kaufman, Mahmoud Moustafa, Simone Derzi, Roupen Hatzakorzian, William Lipishan
PURPOSE: A prolonged seated time after intrathecal injection of hyperbaric bupivacaine and morphine is related to the incidence of hypotension during Cesarean delivery, but results in a high incidence of pain during peritoneal closure. We conducted this study to determine the effect of the addition of intrathecal fentanyl on the relationship between seated time and hypotension and intraoperative analgesia requirements. METHODS: Women undergoing Cesarean delivery were randomized to receive an intrathecal injection of either 11...
July 24, 2017: Canadian Journal of Anaesthesia, Journal Canadien D'anesthésie
https://www.readbyqxmd.com/read/28713516/sequential-compression-pump-effect-on-hypotension-due-to-spinal-anesthesia-for-cesarean-section-a-double-blind-clinical-trial
#16
Fatemeh Javaherforoosh Zadeh, Mostafa Alqozat, Reza Akhond Zadeh
BACKGROUND: Spinal anesthesia (SA) is a standard technique for cesarean section. Hypotension presents an incident of 80-85% after SA in pregnant women. OBJECTIVE: To determine the effect of intermittent pneumatic compression of lower limbs on declining spinal anesthesia induced hypotension during cesarean section. METHODS: This double-blind clinical prospective study was conducted on 76 non-laboring parturient patients, aged 18-45 years, with the American Society of Anesthesiologist physical status I or II who were scheduled for elective cesarean section at Razi Hospital, Ahvaz, Iran from December 21, 2015 to January 20, 2016...
May 2017: Electronic Physician
https://www.readbyqxmd.com/read/28708665/hyperbaric-versus-isobaric-bupivacaine-for-spinal-anesthesia-systematic-review-and-meta-analysis-for-adult-patients-undergoing-noncesarean-delivery-surgery
#17
REVIEW
Vishal Uppal, Susanne Retter, Harsha Shanthanna, Christopher Prabhakar, Dolores M McKeen
BACKGROUND: It is widely believed that the choice between isobaric bupivacaine and hyperbaric bupivacaine formulations alters the block characteristics for the conduct of surgery under spinal anesthesia. The aim of this study was to systematically review the comparative evidence regarding the effectiveness and safety of the 2 formulations when used for spinal anesthesia for adult noncesarean delivery surgery. METHODS: Key electronic databases were searched for randomized controlled trials, excluding cesarean delivery surgeries under spinal anesthesia, without any language or date restrictions...
November 2017: Anesthesia and Analgesia
https://www.readbyqxmd.com/read/28704246/the-effect-of-glycopyrrolate-on-the-incidence-of-hypotension-and-vasopressor-requirement-during-spinal-anesthesia-for-cesarean-delivery-a-meta-analysis
#18
Selina D Patel, Ashraf S Habib, Sioned Phillips, Brendan Carvalho, Pervez Sultan
BACKGROUND: The objective of this meta-analysis was to determine the efficacy of glycopyrrolate at reducing spinal hypotension during cesarean delivery. METHODS: A literature search was performed to identify randomized controlled trials investigating the effect of glycopyrrolate on spinal-induced hypotension during cesarean delivery. Primary outcomes were intraoperative hypotension and vasopressor requirement (phenylephrine equivalents). Secondary outcomes included heart rate (HR), nausea and vomiting, dry mouth, and Apgar scores...
July 10, 2017: Anesthesia and Analgesia
https://www.readbyqxmd.com/read/28702819/strategies-for-prevention-of-spinal-associated-hypotension-during-cesarean-delivery-are-we-paying-attention
#19
EDITORIAL
Vishal Uppal, Dolores M McKeen
No abstract text is available yet for this article.
July 12, 2017: Canadian Journal of Anaesthesia, Journal Canadien D'anesthésie
https://www.readbyqxmd.com/read/28699041/pulse-rate-and-transit-time-analysis-to-predict-hypotension-events-after-spinal-anesthesia-during-programmed-cesarean-labor
#20
Juan Bolea, Jesús Lázaro, Eduardo Gil, Eva Rovira, José M Remartínez, Pablo Laguna, Esther Pueyo, Augusto Navarro, Raquel Bailón
Prophylactic treatment has been proved to reduce hypotension incidence after spinal anesthesia during cesarean labor. However, the use of pharmacological prophylaxis could carry out undesirable side-effects on mother and fetus. Thus, the prediction of hypotension becomes an important challenge. Hypotension events are hypothesized to be related to a malfunctioning of autonomic nervous system (ANS) regulation of blood pressure. In this work, ANS responses to positional changes of 51 pregnant women programmed for a cesarean labor were explored for hypotension prediction...
July 11, 2017: Annals of Biomedical Engineering
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