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Cesarean; hypotension

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https://www.readbyqxmd.com/read/27898546/lateral-position-for-cesarean-delivery-because-of-severe-aortocaval-compression-in-a-patient-with-marfan-syndrome-a-case-report
#1
John C Coffman, Russell L Legg, Catherine F Coffman, Kenneth R Moran
Prompt recognition and management of hypotension resulting from aortocaval compression syndrome are essential to optimize the maternal and fetal outcomes. Management involves increasing leftward uterine displacement and sometimes full lateral positioning, although lateral position during cesarean delivery is typically considered to be impractical. We report an obstetric patient case of severe aortocaval compression syndrome resulting in hypotension and loss of consciousness that ultimately underwent cesarean delivery under general anesthesia in the lateral position...
November 28, 2016: A & A Case Reports
https://www.readbyqxmd.com/read/27891272/spontaneous-rupture-of-uterine-artery-in-a-14-week-pregnant-woman
#2
João Paulo Mancusi de Carvalho, Luciano Augusto de Carvalho Severo, Maria Helena Mancusi de Carvalho, Marina de Paula Andres, Mariano Tamura Vieira Gomes, Sergio Podgaec
We report a case of uterine artery rupture in a woman at 14 weeks' gestation who presented with abdominal pain, tachycardia, and hypotension and underwent a diagnostic laparoscopy. During this procedure, a spontaneous rupture of the left uterine artery was diagnosed and the surgery was converted into a laparotomy. The artery was bound to its origin and to its distal uterine portion. The patient exhibited excellent postoperative recovery and was discharged two days after the surgery. The pregnancy continued without other maternal or fetal complications, and the patient delivered a healthy newborn via cesarean section at 39 weeks of gestation...
2016: Case Reports in Obstetrics and Gynecology
https://www.readbyqxmd.com/read/27884666/anesthetic-considerations-in-a-parturient-with-congenital-insensitivity-to-pain-with-anhidrosis
#3
Z Pirani, F Qasem, S Katsiris
Congenital insensitivity to pain is a rare autosomal recessive disease characterized by varying degrees of autonomic dysfunction and sensory loss, including nociceptive hyposensitivity. It is this autonomic dysfunction that makes both general and neuraxial anesthesia challenging. Testing the block during neuraxial anesthesia may be difficult and the patient may be prone to hypotension and bradycardia. This case report describes the anesthetic management of a parturient with congenital insensitivity to pain presenting for cesarean delivery...
October 21, 2016: International Journal of Obstetric Anesthesia
https://www.readbyqxmd.com/read/27871603/prophylactic-phenylephrine-infusion-for-the-prevention-of-hypotension-after-spinal-anesthesia-in-the-elderly-a-randomized-controlled-clinical-trial
#4
Fabrice Ferré, Philippe Marty, Laura Bruneteau, Virgine Merlet, Benoît Bataille, Anne Ferrier, Claude Gris, Matt Kurrek, Olivier Fourcade, Vincent Minville, Agnes Sommet
STUDY OBJECTIVE: Hypotension frequently occurs during spinal anesthesia (SA), especially in the elderly. Phenylephrine is effective to prevent SA-induced hypotension during cesarean delivery. The objective of this study was to evaluate the efficacy and safety of prophylactic infusion of phenylephrine after SA for orthopedic surgery in the elderly. DESIGN: This prospective, randomized, double-blind, and placebo-controlled study included 54 patients older than 60 years undergoing elective lower limb surgery under SA (injection of 10 mg of isobaric bupivacaine with 5 μg of sufentanyl)...
December 2016: Journal of Clinical Anesthesia
https://www.readbyqxmd.com/read/27848124/reversible-cerebral-vasoconstriction-syndrome-and-posterior-reversible-encephalopathy-syndrome-associated-with-intracranial-hypotension
#5
Katharina Feil, Robert Forbrig, Franziska S Thaler, Julian Conrad, Suzette Heck, Franziska Dorn, Hans-Walter Pfister, Andreas Straube
BACKGROUND: Reversible cerebral vasoconstriction syndrome (RCVS) and posterior reversible encephalopathy syndrome (PRES) are both rare disorders. The pathophysiology of both diseases is not yet fully understood. METHODS: We report the unique case of a 19-year-old comatose woman who was brought to the ER after a series of generalized tonic-clonic seizures 6 days post peridural anesthesia for cesarean section. Vital signs and initial laboratory testing including urine analysis and drug screening were unremarkable...
November 15, 2016: Neurocritical Care
https://www.readbyqxmd.com/read/27793237/sufentanil-in-combination-with-low-dose-hyperbaric-bupivacaine-in-spinal-anesthesia-for-cesarean-section-a-randomized-clinical-trial
#6
Alexandre Dubeux Dourado, Ruy Leite de Melo Lins Filho, Raphaella Amanda Maria Leite Fernandes, Marcelo Cavalcanti de Sá Gondim, Emmanuel Victor Magalhães Nogueira
A double blind randomized clinical trial of sufentanil as an adjunct in spinal anesthesia for cesarean section and, thereby, be able to reduce the dose of bupivacaine, a local anesthetic, with the same result of an anesthetic block with higher doses but with fewer perioperative side effects, such as hypotension.
November 2016: Brazilian Journal of Anesthesiology
https://www.readbyqxmd.com/read/27789074/prediction-of-hypotension-during-spinal-anesthesia-for-elective-cesarean-section-by-altered-heart-rate-variability-induced-by-postural-change
#7
K Sakata, N Yoshimura, K Tanabe, K Kito, K Nagase, H Iida
BACKGROUND: Maternal hypotension is a common complication during cesarean section performed under spinal anesthesia. Changes in maternal heart rate with postural changes or values of heart rate variability have been reported to predict hypotension. Therefore, we hypothesized that changes in heart rate variability due to postural changes can predict hypotension. METHODS: A total of 45 women scheduled to undergo cesarean section under spinal anesthesia were enrolled...
September 22, 2016: International Journal of Obstetric Anesthesia
https://www.readbyqxmd.com/read/27746565/evaluation-of-antihypotensive-techniques-for-cesarean-section-under-spinal-anesthesia-rapid-crystalloid-hydration-versus-intravenous-ephedrine
#8
Kalpana Rajendra Kulkarni, Amruta Girish Naik, Sunetra Girish Deshpande
BACKGROUND: Spinal anesthesia is a preferred technique over general anesthesia for cesarean delivery. It avoids maternal airway related complications, aspiration and neonatal depression. However hypotension following spinal anesthesia can lead to decrease in uterine blood flow and neonatal hypoxia. AIMS: We aimed to evaluate the efficacy of 15 mL.kg- 1of crystalloid preloading versus prophylactic intravenous bolus of 10 mg ephedrine as an antihypotensive measure for cesarean section...
September 2016: Anesthesia, Essays and Researches
https://www.readbyqxmd.com/read/27720613/an-open-label-randomized-controlled-clinical-trial-for-comparison-of-continuous-phenylephrine-versus-norepinephrine-infusion-in-prevention-of-spinal-hypotension-during-cesarean-delivery
#9
M C Vallejo, A F Attaallah, O M Elzamzamy, D T Cifarelli, A L Phelps, G R Hobbs, R E Shapiro, P Ranganathan
BACKGROUND: During spinal anesthesia for cesarean delivery phenylephrine is the vasopressor of choice but can cause bradycardia. Norepinephrine has both β- and α-adrenergic activity suitable for maintaining blood pressure with less bradycardia. We hypothesized that norepinephrine would be superior to phenylephrine, requiring fewer rescue bolus interventions to maintain blood pressure. METHODS: Eighty-five parturients having spinal anesthesia for elective cesarean delivery were randomized to Group P (phenylephrine 0...
August 28, 2016: International Journal of Obstetric Anesthesia
https://www.readbyqxmd.com/read/27710984/the-effect-of-parturient-height-on-the-median-effective-dose-of-intrathecally-administered-ropivacaine
#10
Xiangdi Yu, Fangxiang Zhang
BACKGROUND: Pain during cesarean delivery is one of the more common reasons for a successful medicolegal claim. However, creating an extensive block area can result in hypotension, so determining the precise dose of local anesthetic is critical. OBJECTIVES: Investigate effects of parturient height on the median effective dose (ED50) of intrathecally-administered ropivacaine. DESIGN: Prospective cross-sectional analytic study. SETTING: Anesthesiology department in a provinicial hospital in China...
September 2016: Annals of Saudi Medicine
https://www.readbyqxmd.com/read/27687377/a-randomized-trial-comparing-prophylactic-phenylephrine-and-ephedrine-infusion-during-spinal-anesthesia-for-emergency-cesarean-delivery-in-cases-of-acute-fetal-compromise
#11
Kajal Jain, Jeetinder Kaur Makkar, Siva Subramani Vp, Shalini Gander, Praveen Kumar
BACKGROUND: Previous evidence showed that use of phenylephrine was associated with higher umbilical artery pH (UA pH) than ephedrine after elective cesarean delivery (CD). However, the best choice of vasopressor and its effect on funic gases in cases of acute fetal compromise require additional studies. METHODS: Ninety parturients showing acute fetal compromise during intrapartum period and taken up for CD (category II) under spinal anesthesia were randomized to receive prophylactic infusion of ephedrine 2...
November 2016: Journal of Clinical Anesthesia
https://www.readbyqxmd.com/read/27687318/-hypotension-and-bradycardia-before-spinal-anesthesia
#12
Carlos Javier Shiraishi Zapata
I report a case of hypotension and bradycardia before spinal anesthesia in a pregnant woman with mild to moderate hypertension treated with nifedipine and methyldopa, scheduled for an elective cesarean delivery. She had the history of neurally-mediated syncopes. Two main factors (increased vagal tone and adverse effects of antihypertensive drugs) could explain the hypotension and bradycardia before spinal anesthesia. Monitoring allowed recognizing the problem and corrected it. Thus, it was avoided a disaster in anesthesia, as hemodynamic changes after spinal anesthesia, they would have joined to previous hypotension and bradycardia, which would have caused even a cardiac arrest...
September 26, 2016: Revista Brasileira de Anestesiologia
https://www.readbyqxmd.com/read/27642568/comparing-the-hemodynamic-effects-of-spinal-anesthesia-in-preeclamptic-and-healthy-parturients-during-cesarean-section
#13
Mahshid Nikooseresht, Mohamad Ali Seif Rabiei, Pooran Hajian, Razieh Dastaran, Nasim Alipour
BACKGROUND: Despite controversies about the safest anesthetic technique for cesarean delivery in severely preeclamptic women, there is evidence that supports the use of spinal anesthesia in this group of patients. OBJECTIVES: This prospective randomized clinical trial was designed to determine the hemodynamic effects of low-dose spinal bupivacaine and the incidence of spinal anesthesia-associated hypotension in severely preeclamptic and healthy parturients undergoing cesarean sections...
June 2016: Anesthesiology and Pain Medicine
https://www.readbyqxmd.com/read/27625478/phenylephrine-infusion-for-spinal-induced-hypotension-in-elective-cesarean-delivery-does-preload-make-a-difference
#14
Brandi A Bottiger, Dmitri S Bezinover, Berend Mets, Priti G Dalal, Jansie Prozesky, Serdar Ural, Sonia Vaida
BACKGROUND AND AIMS: Patients undergoing elective cesarean delivery (CD) have a high-risk of spinal-induced hypotension (SIH). We hypothesized that a colloid preload would further reduce SIH when compared with a crystalloid preload. MATERIAL AND METHODS: Eighty-two healthy parturients undergoing elective CD were included in the study. Patients were randomly assigned to two groups (41 patients in each group) to receive either Lactated Ringer's solution (1500 ml) or hydroxyethyl starch (6% in normal saline, 500 ml) 30 min prior to placement of spinal anesthesia...
July 2016: Journal of Anaesthesiology, Clinical Pharmacology
https://www.readbyqxmd.com/read/27614051/very-low-rate-of-patient-related-adverse-events-associated-with-the-use-of-intraoperative-cell-salvage
#15
Diana DeAndrade, Jonathan H Waters, Darrell J Triulzi, Louis Alarcon, Mary Kay Wisniewski, Robert Dyga, Mark H Yazer
BACKGROUND: The rate of patient-related clinical adverse events (AEs) associated with the use of intraoperative cell salvage (ICS) was analyzed. STUDY DESIGN AND METHODS: The perfusion service and electronic risk management databases in a nine-hospital regional health care system were reviewed over an approximately 11-year period. The number of ICS cases performed during this period and basic patient demographics were also extracted. RESULTS: There were 43,198 patients for whom ICS was utilized during the study period...
September 9, 2016: Transfusion
https://www.readbyqxmd.com/read/27605955/a-randomised-controlled-trial-comparing-weight-adjusted-dose-versus-fixed-dose-prophylactic-phenylephrine-infusion-on-maintaining-systolic-blood-pressure-during-caesarean-section-under-spinal-anaesthesia
#16
Lucy Mwaura, Vitalis Mung'ayi, Jimmie Kabugi, Samina Mir
BACKGROUND: Spinal anaesthesia is the standard of care for elective caesarean delivery. It has advantages over general anaesthesia. However the sympathetic blockade induced by spinal anaesthesia results in an 80 percent incidence of hypotension without prophylactic management. Current evidence supports co-loading with intravenous fluids in conjunction with the use of vasopressors as the most effective way to prevent and treat the hypotension. Phenylephrine is the accepted vasopressor of choice in the parturient...
June 2016: African Health Sciences
https://www.readbyqxmd.com/read/27588932/intravenous-oxytocin-use-to-decrease-blood-loss-during-scheduled-cesarean-delivery-a-randomized-double-blinded-controlled-trial-oxytrial
#17
Labib M Ghulmiyyah, Ihab M Usta, Ghina Ghazeeri, Nael Taher, Gael Abu-Ghannam, Hani Tamim, Anwar H Nassar
Objective The objective of this study was to determine the optimal dose of intravenous oxytocin administered during cesarean delivery (CD) to decrease the amount of blood loss. Methods Out of a total of 226 women presenting for CD, 189 patients were randomized into three groups by a computer-generated random number sequence table. Low-risk women with singleton term pregnancies undergoing scheduled CD were assigned to receive 20, 30, or 40 units (U) of oxytocin diluted in 500 mL of lactated Ringer solution intraoperatively...
September 2, 2016: American Journal of Perinatology
https://www.readbyqxmd.com/read/27578231/randomized-controlled-trial-comparing-ondansetron-and-placebo-for-the-reduction-of-spinal-anesthesia-induced-hypotension-during-elective-cesarean-delivery-in-egypt
#18
Nabih I El Khouly, Ashraf M Meligy
OBJECTIVE: To evaluate the effect of prophylactic ondansetron on spinal anesthesia-induced hypotension and bradycardia among patients undergoing elective cesarean deliveries. METHODS: A prospective, double-blind, randomized, placebo-controlled trial enrolled patients aged 20-40years scheduled for elective cesarean delivery under spinal anesthesia between January 1, 2015 and January 31, 2016 at Menoufia University Hospital, Egypt. Patients were randomized to receive intravenous ondansetron 4mg in 10mL of saline or 10mL of saline...
November 2016: International Journal of Gynaecology and Obstetrics
https://www.readbyqxmd.com/read/27555198/randomized-study-of-postcesarean-analgesia-with-intrathecal-morphine-alone-or-combined-with-clonidine
#19
Francisco A E Carvalho, Sérgio B Tenório, Fabiano T Shiohara, Luiz R Maia, Angela Mota
STUDY OBJECTIVE: To investigate the efficacy of the combination of intrathecal morphine with clonidine in comparison with 2 doses of intrathecal morphine alone for postcesarean analgesia. DESIGN: Prospective, double-blinded, randomized clinical trial. SETTING: Maternity ward of Hospital Santa Cruz, Curitiba, Paraná, Brazil (operating room and ward). PATIENTS: The study included 195 American Society of Anesthesiologist I to III singleton parturients undergoing elective cesarean section...
September 2016: Journal of Clinical Anesthesia
https://www.readbyqxmd.com/read/27555124/the-use-of-sugammadex-in-a-pregnant-patient-with-wolff-parkinson-white-syndrome
#20
Turker Sengul, Ayten Saracoglu, Sibel Sener, Olgac Bezen
Wolff-Parkinson-White (WPW) syndrome is a rare pre-excitation syndrome which develops when atrioventricular conduction occurs through a pathologic accessory pathway known as the bundle of Kent instead of atrioventricular node, hence resulting in tachycardia. Patients with WPW syndrome may experience various symptoms arising from mild-to-moderate chest disease, palpitations, hypotension, and severe cardiopulmonary dysfunction. These patients are most often symptomatic because of cardiac arrhythmias. In this case report, we present an uneventful anesthetic management of a pregnant patient with WPW syndrome undergoing cesarean delivery...
September 2016: Journal of Clinical Anesthesia
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