Body height and the spread of spinal anaesthesia for caesarean section: a prospective controlled trial

She, Ying-Jun; Zheng, Xiaochun; Zhao, Baisong; Zeng, Mingbing; Tan, Yunpu; Song, Xingrong

doi:10.1111/aas.12928

Cited by 3 publications

(5 citation statements)

References 20 publications

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“…Also, the shorter group was associated with faster onset time to T6 level and a higher incidence of hypotension. And this suggested that the shorter group has a faster spread of spinal anesthesia, which were similar to some studies and different from Norris report [ 1 , 4 , 20 , 21 ]. However, in addition to height, there were significant differences in weight, body mass index, vertebral column length, abdominal girth, amniotic fluid index and weight gain among the basic parameters of patients in the two groups grouped by height in our study.…”

Section: Discussionsupporting

confidence: 54%

“…After enrolment, parturients were allocated into two groups according to their height: shorter group (Group S, body height was shorter than 158 cm) and taller group (Group T, body height was taller than 165 cm). The cut-off point for body height was based on both the characteristics of parturients height parameters in Chinese city and our department’s data derived from our previous study [ 21 , 23 ].…”

Section: Methodsmentioning

confidence: 99%

“…And the effect of body height on spinal anesthesia is still arguable, with inconsistent results reported in the literature [ 3 , 4 , 9 , 20 – 22 ]. Our previous study showed no significant difference in spinal ropivacaine dose requirement between taller and shorter pregnant women [ 21 ]. However, the limitation of this study was that the difference in average height between the taller and shorter groups was small, and this may influence the spinal dosage in pregnant women with more significant height differences.…”

Section: Introductionmentioning

confidence: 99%

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The impact of height on the spread of spinal anesthesia and stress response in parturients undergoing caesarean section: a prospective observational study

She

Liu

et al. 2021

BMC Anesthesiol

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Background The spread of spinal anesthesia was influenced by many factors, and the effect of body height on spinal anesthesia is still arguable. This study aimed to explore the impact of height on the spread of spinal anesthesia and the stress response in parturients. Methods A total of ninety-seven parturients were allocated into two groups according to their height: the shorter group (body height was shorter than 158 cm) and taller group (body height was taller than 165 cm). Spinal anesthesia was performed with the same amount of 12 mg plain ropivacaine in mothers of different heights. The primary outcome of the study was the success or failure of the spinal anesthesia. The secondary outcomes of the study were stress response, time to T6 sensory level, the incidence of hypotension, the satisfaction of abdominal muscle relaxation and patient VAS scores. Results The rate of successful spinal anesthesia in the shorter group was significantly higher than that in the taller group (p = 0.02). The increase of maternal cortisol level in the shorter group was lower than that in the taller group at skin closure (p = 0.001). The incidence of hypotension (p = 0.013), time to T6 sensory block (p = 0.005), the quality of abdominal muscle relaxation (p < 0.001), and VAS values in stretching abdominal muscles and uterine exteriorization (p < 0.001) in the shorter group were significantly different from those in the taller group. Multivariate analysis showed that vertebral column length (p < 0.001), abdominal girth (p = 0.022), amniotic fluid index (p = 0.022) were significantly associated with successful spinal anesthesia. Conclusions It’s difficult to use a single factor to predict the spread of spinal anesthesia. Patient’s vertebral column length, amniotic fluid index and abdominal girth were the high determinant factors for predicting the spread of spinal anesthesia. Trials registration ChiCTR-ROC-17012030 (Chictr.org.cn), registered on 18/07/2017.

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Section: Discussionsupporting

confidence: 54%

Section: Methodsmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

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The impact of height on the spread of spinal anesthesia and stress response in parturients undergoing caesarean section: a prospective observational study

She

Liu

et al. 2021

BMC Anesthesiol

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“…Another factor that influences the spread of anesthesia is the position and baricity of local anesthesia 30 . Measures to avoid high spinal block are low dose local anesthesia 31 , adjusting the dose of bupivacaine according to the patients height 5,6 and BMI 8,31 , slow injection of local anesthesia 28 , administering local anesthesia in sitting position 32 and isobaric local anesthesia 30 .…”

Section: Risk Factorsmentioning

confidence: 99%

“…It is further exacerbated by aorto-caval compression by the gravid uterus when the woman lies in a supine position and by the dose of local anesthetics 4 . The optimal dosage of local anesthetics for a pregnant woman is variable due to woman's body height 5,6 weight 7,8 intra-abdominal pressure 9 and lumbosacral cerebral spinal volume 9,10 . Spinal anesthesia is development.…”

Section: Introductionmentioning

confidence: 99%

Pre-delivery hypotension after spinal anesthesia during cesarean section and its associated factors at Jigme Dorji Wangchuck National Referral Hospital, Bhutan

Yoezer

Tenzin²,

Tshering³

et al. 2021

Bhutan Health Journal

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Introduction: The current choice of anesthesia for the cesarean section is spinal anesthesia. However, hypotension is the major complication. If promptly not recognized and treated, it increases the morbidity and mortality of the mother and fetus. This study was conducted to evaluate the rate of pre-delivery hypotension and risk factors following spinal anesthesia for cesarean section at the National Referral Hospital in Bhutan. Methods: A cohort study was conducted from 1st October 2018 to 30th June 2019 on 350 women undergoing cesarean section under spinal anesthesia. Pre-delivery hypotension was defined as systolic blood pressure < 100 mm Hg. The association of factors for hypotension was tested using multivariable binary logistic regression using a forward stepwise model. A p-value < 0.05 was considered significant. Results: The rate of pre-delivery hypotension was 74.6 % (n=261). History of hypertension during pregnancy (Adjusted OR 0.25, [0.11-0.60], p=0.013), prophylaxis use of ephedrine (Adjusted OR 0.45, [0.22-0.92], p= 0.024) and ondansetron (Adjusted OR 0.43, [0.22-0.82], p= 0.010),longer preoperative fasting duration (Adjusted OR 1.12, [1.01-1.21], p=0.024,), sensory block level <= T4 (Adjusted OR 3.4, [1.8-6.4], p=<0.001) and baseline systolic blood pressure less than or equal to 120 mmHg (Adjusted OR 2.8, [1.5-5.1], p=0.001) were significant risk factors. Conclusions: This study conduces that the rate of pre-delivery hypotension following spinal anesthesia in a cesarean section was high among women undergoing cesarean section. It is alarming as around two-third of women and fetus undergoing cesarean section under spinal anesthesia are at risk of consequences of hypotension. Most of the risk factors in the study are modifiable. The study suggests that if the anesthesia provider intervenes in managing the modifiable risk factors and treat hypotension promptly, it can help reduce the risk of women and fetus to spinal hypotension consequences.

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Effect of height versus height/weight-based spinal bupivacaine on maternal hemodynamics for elective cesarean in short stature patients: a randomized clinical trial

Subedi,

Thapa,

Prajapati

et al. 2023

J Anesth

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Body height and the spread of spinal anaesthesia for caesarean section: a prospective controlled trial

Abstract: The taller and shorter patients did not respond differently to modest intrathecal doses of ropivacaine. However, a larger dose of ropivacaine was associated with an increased incidence of hypotension in shorter patients compared to that in taller patients.

Cited by 3 publications

References 20 publications

The impact of height on the spread of spinal anesthesia and stress response in parturients undergoing caesarean section: a prospective observational study

The impact of height on the spread of spinal anesthesia and stress response in parturients undergoing caesarean section: a prospective observational study

Pre-delivery hypotension after spinal anesthesia during cesarean section and its associated factors at Jigme Dorji Wangchuck National Referral Hospital, Bhutan

Effect of height versus height/weight-based spinal bupivacaine on maternal hemodynamics for elective cesarean in short stature patients: a randomized clinical trial

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