Leg Compression Versus Control for Prevention of Spinal Anesthesia Induced Hypotension in Elective Cesarean Delivery: A Meta-Analysis of Randomized Controlled Trials

Wan, Li; Shen, Pei‐Ying; Zhang, Shuxian; Wang, Lizhong

doi:10.1016/j.jopan.2021.10.011

Cited by 5 publications

(3 citation statements)

References 24 publications

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“…Bupivacaine is a commonly used amide local anesthetic for regional anesthesia. 10 As reported by Yahalom et al, 11 intrathecal bupivacaine at a dose of 7.5 mg/kg leads to insensitivity to painful stimuli on the forearm, respiratory depression, and symptoms of high spinal anesthesia resulting in death in approximately 30 seconds. However, spinal anesthesia performed with an intrathecal bupivacaine dose of 3.75 mg/kg maintains motor and sensory functions in the forearm while establishing spinal anesthesia with a normal respiratory pat-tern.…”

Section: Discussionmentioning

confidence: 87%

Rat Model: Intrathecal Lipid for Total Spinal BlockInduced Hemodynamic Instability

Darçın

2023

J Clin Pract Res

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Objective: This study aimed to assess the potential of intrathecal administration of lipid emulsions as a targeted therapeutic strategy to mitigate the hemodynamic consequences of high or total spinal anesthesia induced by bupivacaine in a rat model. Materials and Methods: After receiving approval from Koç University's Local Ethics Board of Animal Experiments, 14 adult female Wistar Albino rats were randomized into two groups: Lipid and Saline. After inducing a high spinal block, each group was treated with either intrathecal lipid emulsions or isotonic saline solutions, respectively. Hemodynamic parameters such as systolic, diastolic, and mean arterial blood pressures, as well as heart rate, were continuously monitored. A histological analysis was conducted upon completion of the study. Results:The Lipid group exhibited a significant increase in mean systolic (p=0.002), diastolic (p=0.002), and arterial pressures (p=0.002) compared to the Saline group. The mean pulse rate also differed significantly between the groups (p=0.009). Notably, while all rats in the Saline group succumbed, only two fatalities occurred in the Lipid group, with the other five rats surviving (p=0.021). Conclusion:This study suggests that intrathecal administration of lipid emulsions can serve as a rapid and effective intervention to counteract the hypotension and bradycardia induced by high or total spinal anesthesia with bupivacaine in rats. While these findings are promising, further experimentation and clinical trials are required to confirm this method's potential, focusing on its long-term safety, efficacy, and the establishment of an optimal administration protoco.

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Section: Discussionmentioning

confidence: 87%

Rat Model: Intrathecal Lipid for Total Spinal BlockInduced Hemodynamic Instability

Darçın

2023

J Clin Pract Res

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“…In a meta-analysis of 12 studies involving 787 patients, compression stockings significantly reduced the incidence of hypotension during caesarean section versus no compression (RR 0.45, 95% CI, 0.32 to 0.62, I2 ¼ 81%). 6 Leg compression stockings also reduced maternal nausea and vasopressor requirement and increased maternal comfort, whatever the mode of anaesthesia used. 7 Thus, the experts state on the clinical practice of compression stocking use for surgery during pregnancy.…”

Section: Compression Stockingsmentioning

confidence: 92%

“…Compression stockings and left lateral tilt are current practices during surgery in pregnant women to provide haemodynamic stability and avoid vasoplegia and pooling of blood in the lower limbs. In a meta-analysis of 12 studies involving 787 patients, compression stockings significantly reduced the incidence of hypotension during caesarean section versus no compression (RR 0.45, 95% CI, 0.32 to 0.62, I2 = 81%) 6 . Leg compression stockings also reduced maternal nausea and vasopressor requirement and increased maternal comfort, whatever the mode of anaesthesia used 7 …”

Section: Rationale and Updated Recommendationsmentioning

confidence: 99%

European guidelines on peri-operative venous thromboembolism prophylaxis: first update.

En-Asseri,

Lucas,

Nizard

et al. 2024

European Journal of Anaesthesiology

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Effect of pneumatic leg compression on phenylephrine dose for hypotension prophylaxis via variable rate infusion at cesarean delivery: an unblinded randomized controlled trial

Yao,

Huang,

Dong

et al. 2024

International Journal of Obstetric Anesthesia

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Leg Compression Versus Control for Prevention of Spinal Anesthesia Induced Hypotension in Elective Cesarean Delivery: A Meta-Analysis of Randomized Controlled Trials

Cited by 5 publications

References 24 publications

Rat Model: Intrathecal Lipid for Total Spinal BlockInduced Hemodynamic Instability

Rat Model: Intrathecal Lipid for Total Spinal BlockInduced Hemodynamic Instability

European guidelines on peri-operative venous thromboembolism prophylaxis: first update.

Effect of pneumatic leg compression on phenylephrine dose for hypotension prophylaxis via variable rate infusion at cesarean delivery: an unblinded randomized controlled trial

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