Association between intraoperative phenylephrine administration and umbilical artery pH in women with hypertensive disorders of pregnancy: a retrospective cohort study

Kaneko, Takahiko; Kariya, Nobutaka; Hirose, Munetaka

doi:10.1007/s00540-018-2572-y

Cited by 3 publications

(3 citation statements)

References 29 publications

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“…For those patients with continuous epidural analgesia, sufentanil is only used in the epidural space, the analgesic effect is not so good although the dosage is large, sufentanil can be absorbed into the blood through the venous plexus of the epidural space, increasing the risk of neonatal respiratory depression [20]; Ropivacaine not only blocks the sensory nerve, but also has certain blocking effect on the motor nerve, and even impairs the breath-holding force of the second stage of labor [21,22]. In the current study, ropivacaine plus sufentanil were delivered either via continuous subarachnoid analgesia (CSA group) or continuous epidural analgesia (EA group), the MAP, VAS and SVR of both groups decreased, indicating that labor analgesia can alleviate the stress response of the parturients.…”

Section: Discussionmentioning

confidence: 99%

Effect of continuous spinal anesthesia on the hemodynamics of labor analgesia in hypertensive pregnant women: a randomized clinical trial

Han

2023

Preprint

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Background: To evaluate whether the LiDCO-rapid monitor had any advantages compared to continuous epidural analgesia to bring beneficial for hypertensive pregnant women and their newborns. Methods: In total 160 parturients with hypertensive disorder complicating pregnancy were enrolled and randomly divided into continuous spinal analgesia group (CSA) and continuous epidural analgesia group (EA). The LiDCO-rapid system was used to monitor the hemodynamic changes of all participants. The inflammatory factors and stress response hormones were measured in the participants' serum. Results: The first stage of labor in CSA was longer than EA (P < 0.05); the MAP, VAS and SVR value in CSA were lower than EA group at T1, T3 and T4 (P < 0.05); in contrast, the CO in CSA at T3 and T4 was higher than in EA (P < 0.05). The oxytocin was more often used whereas the antihypertensive drugs were less used in CSA as compared to EA. The level of TNF-α, IL-6, Cor in the CSA at T5 was lower than the EA group (P < 0.05), and the level of TNF-α in the CSA group at T7 was lower than the EA group (P < 0.05). Conclusion: For pregnant women with hypertension during pregnancy, continuous spinal analgesia can improve the oxygen supply of the fetus. Since the advantageous effect is definite and circulatory system is stable, it is recommended to implement continuous spinal analgesia early in the labor process, which can effectively decrease stress response and inflammatory factors that having benefits for both parturient and fetus. Trial registration: ChiCTR-INR-17012659 Date of registration: 13/09/2017

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Section: Discussionmentioning

confidence: 99%

Effect of continuous spinal anesthesia on the hemodynamics of labor analgesia in hypertensive pregnant women: a randomized clinical trial

Han

2023

Preprint

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“…For those patients with continuous epidural analgesia, sufentanil is only used in the epidural space, the analgesic effect is not so good although the dosage is large, sufentanil can be absorbed into the blood through the venous plexus of the epidural space, increasing the risk of neonatal respiratory depression [ 23 ]; Ropivacaine not only blocks the sensory nerve, but also has certain blocking effect on the motor nerve, and even impairs the breath-holding force of the second stage of labor [ 24 , 25 ]. In the current study, ropivacaine plus sufentanil were delivered either via continuous subarachnoid analgesia (CSA group) or continuous epidural analgesia (EA group), the MAP, VAS and SVR of both groups decreased, indicating that labor analgesia can alleviate the stress response of the parturients.…”

Section: Discussionmentioning

confidence: 99%

Effect of continuous spinal anesthesia on the hemodynamics of labor analgesia in hypertensive pregnant women: a comparative, randomized clinical trial

Han

2023

BMC Anesthesiol

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Background To observe the changes in hemodynamic, stress and inflammatory responses during labor and their labor outcomes after continuous spinal anesthesia labor analgesia for hypertensive pregnant women, and to evaluate whether the continuous spinal anesthesia had any advantages compared to continuous epidural analgesia for hypertensive pregnant women and their newborns. Methods A total of 160 hypertensive pregnant women were selected and randomly divided into continuous spinal anesthesia analgesia group (CSA group) and continuous epidural analgesia group (EA group). Participant age, height, weight and gestational week were recorded; MAP, VAS score, CO and SVR were recorded after the onset of regular uterine contractions (T0), 10 min after analgesia (T1), 30 min (T2), 60 min (T3), when the uterine opening was complete (T4) and when the fetus was delivered (T5); the duration of the first stage of labor and the second stage of labor were recorded; the number of cases of treatment with oxytocin and antihypertensive therapy, mode of delivery, eclampsia and postpartum hemorrhage were counted; pregnant women Bromage scores were recorded at T2. We also recorded neonatal weight, Apgar scores at 1, 5 and 10 min after birth; arterial blood gas analysis of the umbilical cord was performed in newborns; finally, TNF-α, IL-6, and cortisol in pregnant women venous blood were measured at T0, T5, and 24 h after delivery (T7). The number of successful compressions and the total drug dosage administered by the analgesic pump were recorded for both groups. Results The first stage of labor in CSA was longer than EA (P < 0.05); the MAP, VAS and SVR value in CSA were lower than EA group at T1, T3 and T4 (P < 0.05); in contrast, the CO in CSA at T3 and T4 was higher than in EA (P < 0.05). The oxytocin was more often used whereas the antihypertensive drugs were less used in CSA as compared to EA. The level of TNF-α, IL-6, Cor in the CSA at T5 was lower than the EA group (P < 0.05), and the level of TNF-α in the CSA group at T7 was lower than the EA group (P < 0.05). Conclusion For pregnant women with hypertension during pregnancy, continuous spinal anesthesia labor analgesia has no significant effect on the final mode of delivery, but shows precise analgesic effect and stabilizes circulatory system, it is recommended to perform continuous spinal anesthesia early in labor for hypertensive pregnant women, which can effectively reduce the stress reaction. Trial registration ChiCTR-INR-17012659. Date of registration: 13/09/2017.

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“…We read with great interest the study by Kaneko et al [1]. Kaneko et al first reported the influence of vasopressor in parturients with the hypertensive disorder of pregnancy.…”

mentioning

confidence: 97%

The choice of vasopressor and umbilical artery pH

Park

Kim

2019

J Anesth

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Association between intraoperative phenylephrine administration and umbilical artery pH in women with hypertensive disorders of pregnancy: a retrospective cohort study

Cited by 3 publications

References 29 publications

Effect of continuous spinal anesthesia on the hemodynamics of labor analgesia in hypertensive pregnant women: a randomized clinical trial

Effect of continuous spinal anesthesia on the hemodynamics of labor analgesia in hypertensive pregnant women: a randomized clinical trial

Effect of continuous spinal anesthesia on the hemodynamics of labor analgesia in hypertensive pregnant women: a comparative, randomized clinical trial

The choice of vasopressor and umbilical artery pH

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