Continuous spinal anesthesia for cesarean section in a parturient with severe preeclampsia

Overdyk, Frank J.; Harvey, Susan C.

doi:10.1016/s0952-8180(98)00066-x

Cited by 8 publications

(2 citation statements)

References 33 publications

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“…A case report by Overdyk and Harvey [48] has described the first use of a continuous spinal anesthetic technique for cesarean delivery in a morbidly obese parturient with severe preeclampsia. They suggest that this is a viable alternative anesthetic method for operative delivery when epidural anesthesia cannot be established.…”

Section: ) the Role Of Spinal Anesthesia In Severe Preeclampsiamentioning

confidence: 99%

Recent advances in obstetric anesthesia

Farragher

Datta

2003

Journal of Anesthesia

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The low-dose technique of combined spinal/epidural analgesia is to be welcomed in obstetrics. Its merits include rapid onset of analgesia, with the flexibility of an epidural technique, and high maternal satisfaction. It is a safe and effective technique. Pulse oximetry should be employed when using intrathecal opioids. Commercially available combined-needle devices may make this technique more attractive to users. The role of spinal anesthesia for emergency cesarean section in severe preeclampsia has been reevaluated recently. We consider it a feasible option for those severely preeclamptic women requiring urgent cesarean section who do not have an epidural catheter in place. The choice of anesthetic technique for this patient population should be made on clinical judgment and not on anticipated hemodynamic changes. Spinal anaesthesia for cesarean section is associated with hypotension; however, certain interventions may reduce the incidence and severity of the hypotension. An increase in cardiac output appears to be key in attenuating the hypotensive response to spinal anesthesia. Colloids have exhibited most success in this regard. At our institution, we do not delay spinal anesthesia for urgent cesarean section in order to administer a predetermined volume of fluid; in such cases, we simultaneously administer a fluid preload and spinal anesthesia. Recent studies regarding the use of cell savers for blood conservation in obstetrics are based on small numbers of patients. These studies show great promise, particularly with the modern emphasis on avoiding blood transfusion, which can be massive in this usually young patient population.

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Section: ) the Role Of Spinal Anesthesia In Severe Preeclampsiamentioning

confidence: 99%

Recent advances in obstetric anesthesia

Farragher

Datta

2003

Journal of Anesthesia

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“…1 The majority of the scientific publications on CSA in obstetrics are case reports of patients with heart disease or other medical disorders. [2][3][4][5][6][7][8][9][10][11][12][13][14][15][16][17][18][19][20][21] There are few studies in the literature assessing the efficacy and safety of CSA in obstetrics, whether descriptive or comparative studies. [22][23][24][25][26] The primary objective of this study was to assess the efficacy and safety of CSA with the catheter-overneedle technique (Spinocath Ò ) when used for elective cesarean delivery.…”

Section: Introductionmentioning

confidence: 99%