Preoperative measurement of maternal abdominal circumference relates the initial sensory block level of spinal anesthesia for cesarean section: An observational study

Kuok, Chi-Hang; Huang, Chung-Hsin; Tsai, Pei‐Shan; Ko, Yuan-Pi; Lee, Wei-Shih; Hsu, Yung-Wei; Hung, Fang-Yu

doi:10.1016/j.tjog.2015.04.009

Cited by 12 publications

(9 citation statements)

References 14 publications

Supporting

Mentioning

Contrasting

Unclassified

Order By: Relevance

“…[ 2 ] Similar finding was reported by Kuok et al ., who found that at 5 th min, increased abdominal circumference lead to higher level of sensory blockade. [ 5 ] This finding was also corroborated by Baysal et al ., who found large abdominal circumference shortened the time taken for sensory block to reach T4. [ 14 ] Effect of intra-abdominal pressure on sensory blockade has been studied with negative results.…”

Section: Discussionsupporting

confidence: 83%

“…Hence, various parturient factors such as height, weight, body mass index, body surface area, truncal length, symphysis-fundal height, abdominal circumference, and weight gain during pregnancy have been studied to know their effects on the level of sensory blockade after spinal anesthesia which have led to inconclusive or negative results. [ 4 5 6 ]…”

Section: Introductionmentioning

confidence: 99%

See 1 more Smart Citation

Correlation between weight of the baby and the level of sensory blockade in spinal anaesthesia for caesarean section: An observational study

2018

View full text Add to dashboard Cite

Background:The spread of local anaesthetics during spinal anaesthesia is affected by various factors and can be unpredictable especially in parturients undergoing caesarean section. Factors like abdominal girth, symphysis fundal height etc have to studied to know their impact on level of sensory blockade. We hypothesized a study to find any correlation between weight of the baby and the level of sensory blockade.Methods:46 parturients posted for elective caesarean section belonging to American Society of Anaesthesiologists (ASA) physical status 1 and 2 were included in the study. Maternal height and weight were noted down before entering operation theatre. All patients were instituted subarachnoid block with 2 cc of 0.5% of hyperbaric bupivacaine in sitting position. Level of sensory blockade was assessed with pin prick along midline of the patient every min till 5th minute and 5 minutes till 15th minute. The birth weight of baby was recorded soon after delivery.Results:The weight of the baby and height of the mother were correlated with the sensory blockade of T4. The number of babies weighing more than 3.5 kgs were 3 in our study out of which 2 babies were associated with maximum sensory blockade at 15th minute. It amounts to 66.7% when compared with 14.7% in babies weighing 2.5 to 3.5 kgs which is suggestive of significance ('P' value of 0.093).Conclusion:There is no statistically significant correlation between weight of the baby and the level of sensory blockade.

show abstract

Section: Discussionsupporting

confidence: 83%

Section: Introductionmentioning

confidence: 99%

Correlation between weight of the baby and the level of sensory blockade in spinal anaesthesia for caesarean section: An observational study

2018

View full text Add to dashboard Cite

show abstract

“…We measured the level of anesthesia only after completing the spinal anesthesia and just before the surgical incision. In a previous study, Kuok et al found a correlation between the AC and sensory block level (right side ρ = 0.43, p =0.005; left side ρ = 0.46, p =0.003) [ 7 ]. However, those researchers did not find a correlation between the incidence of hypotension, defined as ≥30% decrease of blood pressure from baseline, and AC.…”

Section: Discussionmentioning

confidence: 99%

“…However, it is impractical to measure abdominal pressure and attempts to do so can increase the risk of infection. Previous studies have demonstrated associations between larger abdominal circumference (AC) and higher abdominal pressure [ 5 ] and level of sensory block [ 6 , 7 ]. Therefore, it is rational to use AC as a surrogate for abdominal pressure in this study.…”

Section: Introductionmentioning

confidence: 99%

Relationship between Abdominal Circumference and Incidence of Hypotension during Cesarean Section under Spinal Anesthesia

Thomard

Morakul

Wirachpisit

et al. 2020

Anesthesiology Research and Practice

View full text Add to dashboard Cite

Background. Enlarged uterus can compress the inferior vena cava and cause hypotension when lying supine. Previous studies have shown a positive association between the abdominal circumference and size of the uterus. Therefore, the aim of this study was to evaluate the relationship between abdominal circumference and incidence of hypotension during cesarean section under spinal anesthesia. Methods. The study cohort comprised women undergoing cesarean section under spinal anesthesia. Patients were divided into two groups according to the median abdominal circumference (<101 cm and ≥101 cm). Hypotension was defined as a systolic blood pressure of <90 mmHg or mean arterial pressure of <65 mmHg. The primary outcome of this study was the relationship between the incidence of hypotension and the abdominal circumference after spinal anesthesia in term pregnant women. Results. The study cohort comprised 100 women. The incidence of hypotension did not differ between the groups (71.42% in the smaller vs. 78.43% in the larger abdominal circumference group, p=0.419). However, the decrease in mean arterial pressure and its percentage decrease from baseline were greater in the larger than in the smaller abdominal circumference group (change in mean arterial pressure: 28.33 mmHg (18.66–33.67) in the smaller vs. 36.67 mmHg (23.34–43.34) in the larger abdominal circumference group, p=0.004; percentage decrease: 31.41% (22.74–39.22) in the smaller vs. 38.47% (28.00–44.81) in the larger abdominal circumference group, p=0.022). Conclusions. Large abdominal circumference in pregnancy is associated with greater decreases in mean arterial pressure from baseline. However, the incidence of hypotension defined by standard criteria did not differ between larger and smaller abdominal circumference groups.

show abstract

“…Greene 4 has described 25 factors that affect the spread of spinal anaesthesia but in clinical practice it is hard to isolate one factor and quantify its effect on the spread of spinal anaesthesia from the others. There is a great interest on defining the determinants of spinal anaesthesia spread in recent studies (5)(6)(7)(8)(9). Measures that are practically obtainable and have a predictive value on spinal anaesthesia spread will help the clinicians to predict the spread of spinal anaesthesia for individual patients.…”

Section: Introductionmentioning

confidence: 99%

Hip/Shoulder Width Ratio Alters the Spread of Spinal Anesthesia: A Prospective Observational Study

Cantürk¹,

Hakki²,

Kocaoğlu³

2018

Ulutas Med J

View full text Add to dashboard Cite

Introduction: Many factors have been tested to predict the spread of spinal anesthesia in clinical practice. In the study we aimed to investigate the correlation between hip/shoulder width ratio and spread of spinal anesthesia.Method: Sixty patients were enrolled in this study to determine the correlation between hip/shoulder width ratio and the spread of spinal anesthesia. The L4-L5 interspace, navigated by ultrasonography, was introduced at lateral position with a 25G spinal needle. 3ml 0,5% hyperbaric bupivacaine was injected intrathecal in 15 seconds. Age, height, weight, body mass index, hip/shoulder width ratio and vertebral column length were recorded. Spinal anesthesia spread was assessed at 0, 5, 10, 20, and 30 minutes after spinal anesthesia. Patient was turned supine 5 minutes after intrathecal injection. Multiple linear regression analysis was used to analyze correlation between the spread of spinal anesthesia and age, height, weight, hip/shoulder width ratio, vertebral column length.Results: The study was completed without dropout and sixty participants were included into analysis. There was a strong correlation between the spread of spinal anesthesia and hip/shoulder width ratio (r=0,766; p<0,0001) and a negative correlation with the height and vertebral column length (r= -0,572; -0,738 and p=0, 000; 0, 000 respectively).Conclusion: Cephalad spread of spinal anesthesia with a fixed dose of hyperbaric bupivacaine is strongly correlated with hip/shoulder width ratio and inversely correlated with height and vertebral column length. We may observe more spread with 0, 5% hyperbaric bupivacaine in patients with a greater hip/shoulder ratio and a shorter height.

show abstract

Preoperative measurement of maternal abdominal circumference relates the initial sensory block level of spinal anesthesia for cesarean section: An observational study

Abstract: Parturients with greater abdominal circumference value have a higher level of sensory blockade at 5 minutes after spinal anesthesia. Abdominal circumference cannot predict the maximum sensory blockade level and the incidence of hypotension.

Cited by 12 publications

References 14 publications

Correlation between weight of the baby and the level of sensory blockade in spinal anaesthesia for caesarean section: An observational study

Correlation between weight of the baby and the level of sensory blockade in spinal anaesthesia for caesarean section: An observational study

Relationship between Abdominal Circumference and Incidence of Hypotension during Cesarean Section under Spinal Anesthesia

Hip/Shoulder Width Ratio Alters the Spread of Spinal Anesthesia: A Prospective Observational Study

Contact Info

Product

Resources

About