Vasopressors for the management of hypotension after spinal anesthesia for elective caesarean section. Systematic review and cumulative meta‐analysis

Veeser, M.; Hofmann, Thomas; Roth, R.; Klöhr, S.; Rossaint, Rolf; Heesen, M.

doi:10.1111/j.1399-6576.2011.02646.x

Cited by 137 publications

(93 citation statements)

References 32 publications

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“…The decision for the phenylephrine was based on the mechanism of hypotension (the decrease in SVR) and the safety and efficacy of the drug. (58) With the use of phenylephrine boluses, it was easier to keep the values of haemodynamic parameters closer to baseline values, (59) as it had a faster onset and could be more accurately titrated than other vasoactive drugs. (60) Besides hypotension, other common sideeffects related to hypotension were nausea, vomiting, and dizziness with incidences of around 25%.…”

Section: Discussionmentioning

confidence: 99%

Comparison of haemodynamic parameters between the high and low spinal block in young healthy patients

Poredoš¹,

Novak-Jankovič²

2017

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Background. For some surgical procedures a higher sensory block is needed. However, it is complicated by a higher incidence of hypotension, more bradycardia and nausea and a higher use of vasoactive drugs. In elderly and obstetric population complications have been attributed to the decrease in cardiac output and systemic vascular resistance, especially in a high block (above Th6). The aim of our study was to find the incidence of hypotension and bradycardia after a spinal anaesthesia in young, healthy patients. As young patients compensate more, we aimed to find the difference in haemodynamic variables between the group with a high and the group with a low spinal block and the underlying mechanisms of hypotension. Methods. In a prospective, randomized study 44 American Society of Anaesthesiologists (ASA) 1 patients scheduled for knee arthroscopy under spinal anaesthesia were randomly distributed to a high (group H) and a low (group L) spinal block group. In a group H patients were placed into horizontal, whereas in a group L in 15-degree anti-Trendelenburg position immediately after the spinal block. Haemodynamic parameters were measured continuously noninvasively from 10 min before to 25 min after the spinal block using the CNAPTM device with the LiDCORapid monitor. Results. The differences in haemodynamic parameters between the groups were not statistically significant at all measured times despite a significant difference in the spinal block level (18.5 vs 13.3 dermatomes above S5, p<0.001) and a significant difference in haemodynamic variables

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Section: Discussionmentioning

confidence: 99%

Comparison of haemodynamic parameters between the high and low spinal block in young healthy patients

Poredoš¹,

Novak-Jankovič²

2017

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“…Despite this, the incidence of hypotension was low and it was treated with phenylephrine. The decision for the phenylephrine was based on the mechanism of hypotension (the decrease in SVR) and the safety and efficacy of the drug (58). With the use of phenylephrine boluses, it was easier to keep the values of haemodynamic parameters closer to baseline values (59), as it had a faster onset and could be more accurately titrated than other vasoactive drugs (60).…”

Section: Discussionmentioning

confidence: 99%

Comparison of haemodynamic parameters between the high and low spinal block in young healthy patients

2017

View full text Add to dashboard Cite

Background: For some surgical procedures a higher sensory block is needed. However, it is complicated by a higher incidence of hypotension, more bradycardia and nausea and a higher use of vasoactive drugs. In elderly and obstetric population complications have been attributed to the decrease in cardiac output and systemic vascular resistance, especially in a high block (above Th6). The aim of our study was to find the incidence of hypotension and bradycardia after a spinal anaesthesia in young, healthy patients. As young patients compensate more, we aimed to find the difference in haemodynamic variables between the group with a high and the group with a low spinal block and the underlying mechanisms of hypotension. Methods: in a prospective, randomized study 44 ASA 1 patients scheduled for knee arthroscopy under spinal anaesthesia were randomly distributed to a high (group H) and a low (group L) spinal block group. In a group H patients were placed into horizontal, whereas in a group L in 15-degree anti-Trendelenburg position immediately after the spinal block. Haemodynamic parameters were measured continuously noninvasively from 10 min before to 25 min after the spinal block using the CNAPTM device with the LiDCORapid monitor. Results: The differences in haemodynamic parameters between the groups were not statistically significant at all measured times despite a significant difference in the spinal block level (18.5 vs 13.3 dermatomes above S5, p<0.001) and a significant

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“…The choice of hemodynamic therapy is still a debate, mainly because data in this field during pregnancy M a n u s c r i p t limits to spinal anaesthesia-related hypotension after caesarean section. In the past decades, ephedrine was the main vasopressor administered in the peripartum as it was thought to preserve the uterine blood flow [23][24]. Because neonatal acidosis had been observed with high doses of ephedrine, phenylephrine has been progressively used, sole or associated to ephedrine [24].…”

Section: Symptomatic Diagnosis Monitoring and Treatmentmentioning

confidence: 99%

Cardiovascular emergencies and cardiac arrest in a pregnant woman

Ducloy-Bouthors

Gonzalez-Estevez

Constans

et al. 2016

Anaesthesia Critical Care & Pain Medicine

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Vasopressors for the management of hypotension after spinal anesthesia for elective caesarean section. Systematic review and cumulative meta‐analysis

Abstract: Our analysis could clearly demonstrate a decreased risk of fetal acidosis associated with phenylephrine use. In addition with our findings for BE, this suggests a favorable effect of phenylephrine on fetal outcome parameters. The mechanism of pH depression is not related to pCO(2) .

Cited by 137 publications

References 32 publications

Comparison of haemodynamic parameters between the high and low spinal block in young healthy patients

Comparison of haemodynamic parameters between the high and low spinal block in young healthy patients

Comparison of haemodynamic parameters between the high and low spinal block in young healthy patients

Cardiovascular emergencies and cardiac arrest in a pregnant woman

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