Preoperative anxiety can cause convulsion and severe hypotension immediately after spinal anaesthesia for caesarean delivery: a case report

Moon, Eun-Jin; Go, YoonJu; Woo, Gil; Seo, Hyungseok; Lee, Bong-Jae

doi:10.1177/0300060519873473

Cited by 5 publications

(2 citation statements)

References 18 publications

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“…They reported that one patient developed generalized convulsions which were attributable to pre-operative anxiety. 20 Pre-operative anxiety is a very common phenomenon and has very distressing effects on patients. It can potentially lead to various intra-operative and postoperative complications.…”

Section: Discussionmentioning

confidence: 99%

Pre-operative Anxiety Compounding Intra-operative Hypotension in Parturient women undergoing Cesarean Deliveries under Spinal Anesthesia

Bajwa

Sheraz

Hussain

et al. 2021

JRMC

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OBJECTIVE: To assess the relation of intra-operative hypotension with severity of pre-operative anxiety in patients undergoing caesarean section under spinal anesthesia. STUDY DESIGN: Prospective observational study. PLACE AND DURATION OF STUDY: This study was carried out from June 2017 to May 2018 at anesthesia department of Combined Military Hospital Lahore. METHODOLOGY: One hundred and twenty patients belonging to America Society of Anesthesiology class I and II, undergoing caesarean section under spinal anesthesia were selected. Verbal Analogue Scale for anxiety (VASA) and Straight Trait Anxiety Inventory (STAIs) questionnaire were used to measure pre-operative anxiety. Patients were divided into three groups as mild (VASA<3or STAIs<44), moderate (VASA 4-7 or STAIs 44-55) and severe (VASA 7-10 or STAIs>55) anxiety. Baseline mean arterial pressure was measured. Patients were placed in supine position immediately after induction of spinal anesthesia at L3-L4 or L4-L5 level with 12mg bupivacaine. Blood pressure was measured every two minutes until the delivery of baby. Hypotension was labeled when mean arterial pressure dropped by 20% below the baseline. The effect of level of anxiety on drop in MAP was assessed. RESULTS: Seventeen (14.17%) patients had mild pre-operative anxiety; out of which four (23.53%) developed hypotension. Seventy three (60.83%) patients had moderate anxiety; out of which twenty seven (36.99%) developed hypotension. Thirty (25%) patients had severe anxiety; out of which twenty two (73.33 %) developed hypotension. P-value (0.001) was quite significant. CONCLUSION: It was concluded in our study that severity of pre-operative anxiety has significant effect on intra-operative spinal hypotension.

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Section: Discussionmentioning

confidence: 99%

Pre-operative Anxiety Compounding Intra-operative Hypotension in Parturient women undergoing Cesarean Deliveries under Spinal Anesthesia

Bajwa

Sheraz

Hussain

et al. 2021

JRMC

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“…29 Furthermore, studies have reported serious complications, such as convulsion and severe a hypotension, resulting from preoperative anxiety during the period of induction of regional anesthesia and surgical preparation for cesarean delivery. 30 The preoperative administration of midazolam before spinal anesthesia in patients undergoing cesarean delivery decreased anxiety without the induction of adverse neonatal effects. 31,32 However, in this study, the maternal and neonatal outcomes during the puerperal period in patients in the spinal anesthesia group did not differ according to application of intraoperative sedation.…”

Section: Anesthesia and Analgesiamentioning

confidence: 99%

Spinal Versus General Anesthesia for Cesarean Delivery in Pregnant Women With Moyamoya Disease: A Retrospective Observational Study

Kim

Choi

Kwon

et al. 2022

Anesthesia &Amp; Analgesia

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BACKGROUND: Moyamoya disease, a rare chronic cerebrovascular disease with a fragile vascular network at the base of the brain, can cause ischemic or hemorrhagic strokes or seizures. Precise blood pressure control and adequate analgesia are important for patients with moyamoya disease to prevent neurological events such as ischemia and hemorrhage. This study aimed to compare the intraoperative mean arterial pressure of pregnant women with moyamoya disease according to the mode of anesthesia (general anesthesia versus spinal anesthesia) used during cesarean delivery. METHODS: We retrospectively reviewed the medical records of 87 cesarean deliveries in 74 patients who had been diagnosed with moyamoya disease before cesarean delivery. The primary outcome, intraoperative maximum mean arterial pressure during anesthesia, was compared according to the type of anesthesia administered (general versus spinal anesthesia). Other perioperative hemodynamic data (lowest mean arterial pressure, incidence of hypotension, vasopressor use, and antihypertensive agent use), maternal neurologic symptoms, neonatal outcomes (Apgar scores <7, ventilatory support, and intensive care unit admission), maternal and neonatal length of stay, postoperative pain scores, and rescue analgesic use were assessed as secondary outcomes. RESULTS: While the lowest blood pressure during anesthesia and incidence of hypotension did not differ between the 2 groups, the maximum mean arterial pressure during anesthesia was lower in the spinal anesthesia group than that in the general anesthesia group (104.8 ± 2.5 vs 122.0 ± 4.6; P = .002). Study data did not support the claim that maternal neurologic symptoms differ according to the type of anesthesia used (5.6% vs 9.3%; P = .628); all patients recovered without any sequelae. The postoperative pain scores were lower, and fewer rescue analgesics were used in the spinal anesthesia group than in the general anesthesia group. Other maternal and neonatal outcomes were not different between the 2 groups. CONCLUSIONS: Compared with general anesthesia, spinal anesthesia mitigated the maximum arterial blood pressure during cesarean delivery and improved postoperative pain in patients with moyamoya disease.

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2019

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Preoperative anxiety can cause convulsion and severe hypotension immediately after spinal anaesthesia for caesarean delivery: a case report

Cited by 5 publications

References 18 publications

Pre-operative Anxiety Compounding Intra-operative Hypotension in Parturient women undergoing Cesarean Deliveries under Spinal Anesthesia

Pre-operative Anxiety Compounding Intra-operative Hypotension in Parturient women undergoing Cesarean Deliveries under Spinal Anesthesia

Spinal Versus General Anesthesia for Cesarean Delivery in Pregnant Women With Moyamoya Disease: A Retrospective Observational Study

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