Intervillous Blood Flow During Caesarean Section with Prophylactic Ephedrine and Epidural Anaesthesia

Hollmén, A; Jouppila, R.; Albright, George A.; Jouppila, Pentti; Vierola, H.; Koivula, A.

doi:10.1097/00132586-198510000-00028

Cited by 4 publications

(5 citation statements)

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“…These findings suggest that umbilical placental vascular resistance may be increased during spinal anaesthesia. As there is no evidence from animal or human studies that ephedrine reduces uterine blood flow [19,20], the most likely explanation for these findings is a reduction in uteroplacental blood flow secondary to a reduction in maternal cardiac output. Uterine blood flow has been shown to decrease during spinal anaesthesia in animals [21].…”

Section: Discussionmentioning

confidence: 99%

Maternal and Fetal Haemodynamic Effects of Spinal and Extradural Anaesthesia for Elective Caesarean Section

ROBSON¹

1992

British Journal of Anaesthesia

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Serial haemodynamic investigations were performed in 32 women who were allocated randomly to receive either spinal or extradural anaesthesia for elective Caesarean section. Cardiac output was measured by Doppler and cross-sectional echocardiography at the aortic valve. Doppler flow velocity waveforms were recorded also from the umbilical artery. Preloading with Ringer lactate solution 1 litre increased cardiac output in both groups. After injection of bupivacaine, cardiac output remained increased in the extradural group, but decreased in the spinal group. This was associated with an increase in umbilical artery pulsatility index in the spinal group. Umbilical artery pH was less in the spinal group (7.22 vs 7.27), although no neonate was depressed at birth. The maximum percentage change in cardiac output and umbilical artery pulsatility index correlated with umbilical artery pH (r = 0.54, r = 0.72, respectively). There was no significant correlation with change in arterial pressure.

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Section: Discussionmentioning

confidence: 99%

Maternal and Fetal Haemodynamic Effects of Spinal and Extradural Anaesthesia for Elective Caesarean Section

ROBSON¹

1992

British Journal of Anaesthesia

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“…Nausea & vomiting, chest symptoms and number of ephedrine boluses to treat hypotension were also recorded. The effect of an IV bolus of ephedrine on arterial pressure is transient and lasts for only 10-15 minutes 12 . This study found that the incidence of hypotension was significantly lower in E group when compared to F group (Table II).…”

Section: Discussionmentioning

confidence: 99%

“…infusion of up to 2 liters of IV fluid for intravascular volume expansion 11 or use of vasopressor (ephedrine) may be an effective alternative for hypotension prevention 12 . Ephedrine is a sympathomimetic agent, non-catecholamine-mediated, which directly stimulates alpha and beta adrenergic receptors and producing its hypertensive effects through releasing nor-epinephrine from autonomic nerve endings 12 . On the other hand, IV infusion of Ringer lactate solution may reduce the risk of hypotension but does not eliminate it 11 .…”

mentioning

confidence: 99%

Volume Preload versus Ephedrine Infusion for Prevention of Hypotension Due to Spinal Anesthesia for Cesarean Section

Anam

Rahman

et al. 2019

Med. Today

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Introduction: Spinal anesthesia is used for 95% of planned cesarean sections in Bangladesh. It provides a fast and profound sensory and motor block. However, hypotension is a very common complication of spinal anesthesia during cesarean section, causing significant maternal and fetal morbidity and mortality. It could be associated with severe nausea, vomiting and even unconsciousness and pulmonary aspiration in the mother and for the baby hypoxia, acidosis and neurological injuries may result. Materials and Methods: This prospective randomized comparative study was conducted in the Department of Anesthesiology at Institute of Child and Mother Health (ICMH) from July 2017 to December 2017, on 110 adult pregnant women who underwent caesarean delivery. All study patients were randomly allocated into two groups. Group I (F group) patients received volume preloading with 15 ml/kg Ringer lactate solution before induction of spinal anesthesia and group II (E group) patients received IV ephedrine (5 mg in 1st minute after spinal anesthesia, 5 mg in 2nd minute and thereafter 1 mg in every minute for 15 minutes). Results: A statistically significant difference in the incidence of hypotension between group F (48%) and group E (24%) was found (p = 0.03). Regarding side effects, statistically significant (p = 0.23) incidence of nausea and vomiting was found in group F (20%) in comparison to group E (12%). Conclusion: We conclude that prophylactic IV ephedrine infusion is more effective than fluid preload to prevent spinal anesthesia-induced hypotension during caesarean section without causing significant tachycardia or hypertension. Medicine Today 2019 Vol.31(1): 39-41

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“…Prophylactic IV ephedrine administered either by infusion or multiple bolus injections has been considered the gold standard for preventing and treating hypotension [19]. The effect of an IV bolus of ephedrine on arterial pressure is transient, and it lasts for only 10 -15 minutes [20].…”

Section: Discussionmentioning

confidence: 99%

Volume Preload versus Ephedrine Infusion for Prevention of Hypotension Due to Spinal Anesthesia for Cesarean Section

Ahmed¹,

Hossam²,

Adel³

2016

OJAnes

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Background: Spinal anesthesia is used for 95% of planned cesarean sections in the United States. It provides a fast and profound sensory and motor block. However, hypotension is a very common complication of spinal anesthesia during cesarean section, causing significant morbidity and mortality. It could be associated with severe nausea, vomiting and even unconsciousness and pulmonary aspiration in the mother and for the baby, hypoxia, acidosis, and neurological injuries may result. Methodology: Fifty patients were randomly allocated into two groups. Group I (F group) patients received preloading with 15 ml/kg Ringer lactate before induction of spinal anesthesia, and group II (E group) patients received IV ephedrine (5 mg in 1 st minute after spinal anesthesia and 5 mg in the 2 nd minute and 1 mg every minute after that for 15 minutes). Results: A statistically significant difference in the incidence of hypotension between group F (48%) and group E (24%) was seen, (p-value 0.03). Regarding side effects, the incidence of nausea and vomiting was higher in the group F (20%) when compared to group E (12%), (p-value 0.23). Conclusions: We concluded that IV infusion of ephedrine after induction of spinal anesthesia was more effective than crystalloid preloading in a prevention of hypotension in parturient undergoing cesarean section and did so without causing significant tachycardia.

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Intervillous Blood Flow During Caesarean Section with Prophylactic Ephedrine and Epidural Anaesthesia

Cited by 4 publications

References 0 publications

Maternal and Fetal Haemodynamic Effects of Spinal and Extradural Anaesthesia for Elective Caesarean Section

Maternal and Fetal Haemodynamic Effects of Spinal and Extradural Anaesthesia for Elective Caesarean Section

Volume Preload versus Ephedrine Infusion for Prevention of Hypotension Due to Spinal Anesthesia for Cesarean Section

Volume Preload versus Ephedrine Infusion for Prevention of Hypotension Due to Spinal Anesthesia for Cesarean Section

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