Cardiovascular alterations in the parturient undergoing cesarean delivery with neuraxial anesthesia

Arendt, Katherine W.; Muehlschlegel, Jochen D.; Tsen, Lawrence C.

doi:10.1586/eog.11.79

Cited by 10 publications

(13 citation statements)

References 169 publications

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“…The hemodynamic changes associated with neuraxial anesthesia techniques for cesarean delivery are reviewed elsewhere. 44 In brief, the onset of neuraxial anesthesia results in a decrease in venous tone (preload) and a decrease in SVR often resulting in hypotension. Intrathecal local anesthetic provides a more rapid block onset than epidural local anesthetic.…”

Section: Anesthesia For Cesarean Deliverymentioning

confidence: 99%

“…17 Immediately following delivery, preload is significantly increased due to relief of inferior vena cava obstruction by the gravid uterus and an ''auto-transfusion" of blood from the contracting evacuated uterus. 44,61 This results in an increase in cardiac output through increases in both stroke volume and heart rate. 44 Over the first several days postpartum, extravascular fluid mobilizes into the intravascular compartment, maintaining an elevated preload during this time.…”

Section: Postpartum Monitoringmentioning

confidence: 99%

“…44,61 This results in an increase in cardiac output through increases in both stroke volume and heart rate. 44 Over the first several days postpartum, extravascular fluid mobilizes into the intravascular compartment, maintaining an elevated preload during this time. 17 Concurrently, cardiac output begins to decrease, while the systemic vascular resistance continues to rise over the first few weeks.…”

Section: Postpartum Monitoringmentioning

confidence: 99%

See 2 more Smart Citations

Obstetric anesthesia management of the patient with cardiac disease

Arendt

Lindley

2019

International Journal of Obstetric Anesthesia

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Section: Anesthesia For Cesarean Deliverymentioning

confidence: 99%

Section: Postpartum Monitoringmentioning

confidence: 99%

Section: Postpartum Monitoringmentioning

confidence: 99%

See 1 more Smart Citation

Obstetric anesthesia management of the patient with cardiac disease

Arendt

Lindley

2019

International Journal of Obstetric Anesthesia

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“…Metode tersebut cukup efektif untuk mencegah hipotensi. 1,5,6 Penelitian penggunaan leg wrapping sudah dilakukan di beberapa tempat dan penelitian terakhir dilakukan pada tahun 2014 di India dengan hasil yang serupa dengan penelitian sebelumnya, yaitu angka kejadian hipotensi hanya 10% dari pasien yang dilakukan leg wrapping sebelum anestesi spinal, sedangkan pada pasien yang tidak dilakukan leg wrapping hipotensi terjadi pada 33,33% pasien. 1 Penelitian ini bertujuan untuk menilai efek penggunaan leg wrapping terhadap kejadian hipotensi selama anestesi spinal pada pasien seksio sesarea.…”

Section: Pendahuluanunclassified

Efek Penggunaan Leg Wrapping terhadap Kejadian Hipotensi Selama Anestesi Spinal pada Pasien Seksio Sesarea

Putri¹,

Fuadi²,

Bisri³

2016

jap

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Hipotensi merupakan komplikasi tersering selama anestesi spinal dengan insidensi >80% meskipun telah diberikan cairan preloading, posisi ibu left lateral tilt, dan penggunaan vasopresor. Terdapat teknik lain untuk mencegah terjadi hipotensi, yaitu penggunaan leg wrapping yang dapat memperbaiki aliran balik vena dengan meningkatkan volume darah sentral. Penelitian ini bertujuan menilai efek penggunaan leg wrapping terhadap kejadian hipotensi selama anestesi spinal pada pasien seksio sesarea. Penelitian bersifat eksperimental acak terkontrol buta tunggal dengan randomisasi secara acak sederhana yang melibatkan 40 ibu hamil American Society of Anesthesiologists (ASA) II yang menjalani seksio sesarea dengan anestesi spinal di Central Operating Theatre (COT) lantai 3, Rumah Sakit Dr. Hasan Sadikin Bandung pada bulan Juni-Juli 2015. Subjek penelitian dikelompokkan menjadi dua, yaitu 20 subjek dengan leg wrapping dan 20 subjek tanpa leg wrapping. Tekanan darah dan laju nadi diperiksa setiap dua menit sampai bayi lahir. Data dianalisis dengan uji-t tidak berpasangan dan chi-kuadrat, nilai p<0,05 dianggap bermakna. Analisis statistik menunjukkan kejadian hipotensi pada kelompok tanpa leg wrapping 95% (19 orang) dan 0% pada kelompok dengan leg wrapping dengan perbedaan bermakna (p<0,05). Secara keseluruhan, hemodinamik kelompok dengan leg wrapping lebih stabil dibanding dengan kelompok tanpa leg wrapping. Simpulan, penggunaan leg wrapping sebelum dilakukan anestesi spinal pada pasien yang menjalani seksio sesarea menurunkan angka kejadian hipotensi.

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“…Significant respiratory and cardiovascular physiologic changes occur during pregnancy, in addition pulmonary vascular resistance reduces, (1) thus; the increased volume load to the pulmonary circulation does not cause elevation of pulmonary pressure. (2) A decrease in systemic blood pressure is well recognized during pregnancy; therefore, pulmonary to systemic artery pressure ratio has to be rather higher in pregnancy than in general population. Normal pulmonary artery systolic pressure in general population is established but there is limited data in the normal pregnant population.…”

Section: Introductionmentioning

confidence: 99%

The Estimation of Pulmonary Artery Systolic Pressure in Normal Pregnancy

Gharaibeh¹,

Sharo²,

Atyyat³

et al. 2015

JRMS

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Objective: To assess the effects of various stages of pregnancy as well as pregnant women age on the level of pulmonary artery systolic pressure. Methods: One hundred and thirty five healthy pregnant women, aged 18 to 42 years, were included in this study. They underwent voluntary transthoracic echocardiogram measurements of pulmonary artery systolic pressure at rest. Three groups of pregnant women were designed according to gestational age; Group 1 included pregnancies less than 13 weeks of gestation and considered as control group. Group II included pregnancies equal to 13 weeks gestation and less than 28 weeks. Group III included those pregnancies with 28 weeks of gestation up to term. Each group included 45 women. The mean pulmonary artery systolic pressure was calculated for each group. Results for groups two and three were compared separately to the control group. The study population was then regrouped according to women's age; Group A included women aged less than 35 years (n=95), Group B included women aged 35 years and above (n=40). Difference in mean pulmonary artery systolic pressure between groups A and B were studied. Results: Lower and upper limits of pulmonary artery systolic pressure during pregnancy were found to be 14 and 45 mmHg. Pulmonary artery systolic pressure during pregnancy showed an increase with maternal age after 35. Marginal change was also noted with gestational age; however that was of no statistical significance. Conclusion: During the different stages of pregnancy, mean pulmonary artery systolic pressure does not alter; however, it may reach high values in healthy asymptomatic women. When interpreting pulmonary artery systolic pressure in pregnancy, age correction may be required since pulmonary artery systolic pressure is found to physiologically increase with increasing pregnant women's age.

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Cardiovascular alterations in the parturient undergoing cesarean delivery with neuraxial anesthesia

Cited by 10 publications

References 169 publications

Obstetric anesthesia management of the patient with cardiac disease

Obstetric anesthesia management of the patient with cardiac disease

Efek Penggunaan Leg Wrapping terhadap Kejadian Hipotensi Selama Anestesi Spinal pada Pasien Seksio Sesarea

The Estimation of Pulmonary Artery Systolic Pressure in Normal Pregnancy

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