Expansão volêmica em raquianestesia para cesariana: comparação entre cristalóide ou colóide

Cardoso, Marcio Vivan; Bliacheriene, Sandra; Freitas, Cláudia R C; Cesar, Daniel Souza; Torres, Marcelo Luís Abramides

doi:10.1590/s0034-70942004000600005

Cited by 6 publications

(3 citation statements)

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“…The findings of the current study were consistent with those of the studies by ShiQin et al, Alimian et al, and Unlugenc et al, showing that higher PB decreased in the presence of crystalloid solution ( 16 - 18 ). However, the current study findings were inconsistent with the findings reported by Kumar et al, that showed higher BP decline in colloid solution group ( 19 ) and with the findings of Cardoso et al, and Osazuwa et al, reporting no significant difference between the two groups regarding BP decline ( 20 , 21 ). BP decline during operation can be attributed to the vascular expansion due to medication and bleeding during operation where preload infusion during spinal anesthesia can prevent it significantly.…”

Section: Discussioncontrasting

confidence: 99%

The Effects of Pre-Spinal Anesthesia Administration of Crystalloid and Colloid Solutions on Hypotension in Elective Cesarean Section

et al. 2018

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BackgroundSpinal anesthesia is an appropriate alternative for general anesthesia in many operations, particularly in cesarean section. However, the induced hypotension is the main drawback of this method. Therefore, the current study aimed at comparing the effects of crystalloid and colloid solutions used as the preload on the post-spinal hypotension and its complications in females who are candidate for elective cesarean section.MethodsThe current randomized, controlled, double-blind study was conducted on the female candidate of elective cesarean section (n = 96; age range: 20 to 40 years). The patients were in their 37 to 42 weeks of gestational age during the experiments. The systolic blood pressure (SBP), diastolic blood pressure (DBP), heart rate (HR) variation, amount of injected ephedrine during surgery, Apgar score at birth, total solution infused after spinal anesthesia, urine output, nausea, and vomiting were comparatively assessed between the two groups.ResultsThe percentages of reduction in SBP and DBP variables in the crystalloid solution were higher than those of the colloid group and the differences were statistically significant (P = 0.042 and P = 0.008, respectively). Average percentage of HR changes was more significant in the crystalloid than the colloid group (P = 0.032). In contrary, administration of the two types of solutions did not result in significant differences in the Apgar scores. The prevalence of nausea and vomiting in the colloid group subjects was lower than those of the crystalloid solution group; however, the differences were not significant.ConclusionsThe current study findings recommend colloid solution to prevent hemodynamic instability after spinal anesthesia. However, the costs and availability of the solution and recommendation of anesthesiologist should be considered. Conduction of further clinical trials with larger sample sizes is recommended.

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Section: Discussioncontrasting

confidence: 99%

The Effects of Pre-Spinal Anesthesia Administration of Crystalloid and Colloid Solutions on Hypotension in Elective Cesarean Section

et al. 2018

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“…Patients received 10 mg of 0.5% hyperbaric bupivacaine combined with 100 g of morphine, at a rate of 1 mL every 15 s. 12 Immediately after the blockade, concomitant hydration of Ringer's lactate (10 mL kg ---1 ) was started. 13 After blockade, the measurement of pregnant women systolic blood pressure (SBP) was recorded every minute on data collection form up to fetus extraction. The level of sensory block was assessed with the pinprick test every minute after the puncture, until it reached the dermatome level of the fifth thoracic nerve root (T5).…”

Section: Anesthetic Techniquementioning

confidence: 99%

Comparison of metaraminol, phenylephrine and ephedrine in prophylaxis and treatment of hypotension in cesarean section under spinal anesthesia

Aragão

Martíns

et al. 2014

Brazilian Journal of Anesthesiology (English Edition)

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Maternal hypotension is a common complication after spinal anesthesia for cesarean section, with deleterious effects on the fetus and mother. Among the strategies aimed at minimizing the effects of hypotension, vasopressor administration is the most efficient. The aim of this study was to compare the efficacy of phenylephrine, metaraminol, and ephedrine in the prevention and treatment of hypotension after spinal anesthesia for cesarean section. Ninety pregnant women, not in labor, undergoing cesarean section were randomized into three groups to receive a bolus followed by continuous infusion of vasopressor as follows: phenylephrine group (50 g + 50 g/min); metaraminol group (0.25 mg + 0.25 mg/min); ephedrine group (4 mg + 4 mg/min). Infusion dose was doubled when systolic blood pressure decreased to 80% of baseline and a bolus was given when systolic blood pressure decreased below 80%. The infusion dose was divided in half when systolic blood pressure increased to 120% and was stopped when it became higher. The incidence of hypotension, nausea and vomiting, reactive hypertension, bradycardia, tachycardia, Apgar scores, and arterial cord blood gases were assessed at the 1st and 5th minutes.There was no difference in the incidence of hypotension, bradycardia, reactive hypertension, infusion discontinuation, atropine administration or Apgar scores. Rescue boluses were higher only in the ephedrine group compared to metaraminol group. The incidence of nausea and vomiting and fetal acidosis were greater in the ephedrine group. The three drugs were effective in preventing hypotension; however, fetal effects were more frequent in the ephedrine group, although transient. Avaliação comparativa entre metaraminol, fenilefrina e efedrina na profilaxia e no tratamento da hipotensão em cesarianas sob raquianestesiaResumo Hipotensão materna é uma complicação comum após raquianestesia em cirurgia cesariana, trazendo efeitos deletérios para o feto e a mãe. Entre as estratégias com o objetivo de minimizar os efeitos da hipotensão, a administração de vasopressores é a mais eficiente. O objetivo deste estudo foi comparar a eficácia da fenilefrina, metaraminol e efedrina na prevenção e tratamento de hipotensão após raquianestesia em cirurgia cesariana. Noventa gestantes que não estavam em trabalho de parto submetidas à cesariana eletiva foram randomizadas em três grupos para receber um bolus, seguido de infusão contínua de vasopressor da seguinte forma: Grupo Fenilefrina (50 g + 50 g/min); Grupo Metaraminol (0,25 mg + 0,25 mg/min); Grupo Efedrina (4 mg + 4 mg/min). A dose da infusão foi dobrada quando a pressão arterial sistólica (PAS) decresceu até 80% dos valores basais e um bolus foi dado quando a PAS decresceu para valores abaixo de 80%. A dose da infusão foi dividida ao meio quando a PAS aumentou até 120% e foi interrompida quando mais elevada. Foram analisadas as incidências de hipotensão, náuseas e vômitos, hipertensão reativa, bradicardia, taquicardia e escores de Apgar no primeiro e quinto minutos e gases de sangue arterial d...

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“…Ancak hipotansiyona hangi düzeyde müdahale edileceği ya da hangi değerlerin hipotansiyon olarak kabul edileceği ile ilgili farklı çalışmalarda çeşitli değerler verilmiştir. Maternal sistolik basıncın 90 mmHg'den düşük olması (26)(27)(28) , 100 mmHg'den düşük olması (29)(30)(31)(32) ya da maternal sistolik basıncın bazal değere göre %10 düşmesi (33) , %20 düşmesi (34,35) , %30 düşmesi (36,37) veya bunların kombinasyonları (3,21,(38)(39)(40)(41)(42)(43)(44)(45) hipotansiyon olarak değerlendirilmiştir. Biz de çalışmamızda, maternal sistolik arter basıncının bazal değere göre %25 oranında ya da sistolik arter basıncının 100 mmHg'nin altına düşmesini hipotansiyon olarak değerlendirdik.…”

Section: Discussionunclassified

The Efficiency Of Preventing Hypotension By Passive Leg Raise Application In Pregnant Women Planned For Cesarean Section Under Spinal Anesthesia

İnce¹,

Sızlan²,

Senkal³

et al. 2019

JARSS

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Hızlı, derin, simetrik duyusal ve motor blok sağlayarak sezaryen için uygun şartları sağlayan spinal anestezide sempatektomiye bağlı bir komplikasyon olan hipotansiyon gebelerde yaklaşık %60-80 arasında görülmektedir. Çalışmamızda, gebelerde pasif bacak kaldırma uygulamasının spinal anestezi sonrası oluşan hipotansiyonu önleme ya da derinliğini azaltmadaki etkinliğini belirlemek amaçlanmıştır. Yöntem: Çalışmaya spinal anestezi ile sezaryen yapılması planlanan 18-40 yaş arası 40 gebe dahil edildi. Tüm hastalara preoperatif 15 ml kg-1 kolloid yüklemesi ve antiasid profilaksisi sonrası L4-5 aralığından 2,2 ml yüksek dansiteli bupivakain intratekal olarak verildi. Enjeksiyon sonrası pasif bacak kaldırma grubundaki hastalar supin pozisyona alınarak ameliyat masası önceden işaretlenmiş olan pozisyona getirilip bacakların belden 30 derecelik açılanması sağlandı. Kontrol grubundaki hastalar ise supin pozisyonda bırakıldı.

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Expansão volêmica em raquianestesia para cesariana: comparação entre cristalóide ou colóide

Cited by 6 publications

References 1 publication

The Effects of Pre-Spinal Anesthesia Administration of Crystalloid and Colloid Solutions on Hypotension in Elective Cesarean Section

The Effects of Pre-Spinal Anesthesia Administration of Crystalloid and Colloid Solutions on Hypotension in Elective Cesarean Section

Comparison of metaraminol, phenylephrine and ephedrine in prophylaxis and treatment of hypotension in cesarean section under spinal anesthesia

The Efficiency Of Preventing Hypotension By Passive Leg Raise Application In Pregnant Women Planned For Cesarean Section Under Spinal Anesthesia

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