Prevention of Peri-Induction Hypertension in Preeclamptic Patients

Pant, Melissa; Fong, Robert; Scavone, Barbara M.

doi:10.1097/01.aoa.0000472701.73468.65

Cited by 3 publications

(3 citation statements)

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“…Patients in Group H were older in age (p<0.001). Intubation response was seen in Group H but not in Group N. This is a known phenomenon, and various drugs have been advocated to reduce this effect (9,10).…”

Section: Discussionmentioning

confidence: 95%

Untitled

2014

Turk J Anesth Reanim

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Section: Discussionmentioning

confidence: 95%

Untitled

2014

Turk J Anesth Reanim

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“…A Cochrane review on prevention of morbidity associated with the haemodynamic response to tracheal intubation listed local anaesthetics, beta-blockers, calcium channel blockers and opioids as effective therapy in blunting the response and reducing the incidence of arrhythmias associated with intubation 35 . In the obstetric setting, this rise in blood pressure and heart rate can be detrimental in a subset of patients with preeclampsia and needs to be prevented 6 . In this particular group of patients the ideal drug should attenuate this response in the parturient with minimal side-effects for both mother and baby.…”

Section: Discussionmentioning

confidence: 99%

Effect on Neonatal Outcome of Pharmacological Interventions for Attenuation of the Maternal Haemodynamic Response to Tracheal Intubation: A Systematic Review

Aman

Salim

Munshi

et al. 2018

Anaesth Intensive Care

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The primary aim of this systematic review was to assess the effect on neonatal outcome of pharmacological interventions used for attenuation of the haemodynamic response to tracheal intubation in patients undergoing caesarean Section under general anaesthesia. A systematic search of randomised controlled trials from 1990 to 2015 was conducted. The primary outcome measure was the Apgar score at five minutes and secondary outcomes were umbilical arterial blood gas parameters and neurological adaptive capacity scores. Twenty-seven randomised controlled trials (1,689 patients) were included in the qualitative synthesis. Only five studies using opioids (383 patients) and five studies using non-opioid analgesics (358 patients) were subjected to meta-analysis. The Apgar score at five minutes was significantly lower in neonates of opioid-treated mothers (mean difference: −0.29, 95% confidence interval −0.56 to −0.02, P-value=0.03) compared to mothers in the control group; the umbilical arterial pH was lower and there was a higher requirement for tactile stimulation in neonates. No difference was seen in Apgar scores of neonates of mothers administered non-opioid analgesics compared to placebo. No difference was observed in other parameters between opioid- or non-opioid-treated mothers. This review suggests that opioid interventions for attenuation of the haemodynamic response to tracheal intubation in pregnant patients under general anaesthesia affect neonatal Apgar scores at five minutes in neonates but the difference did not appear to be clinically meaningful. We were unable to demonstrate any difference in safety.

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“…However if RA is contraindicated, the intubation response can be attenuated with boluses of esmolol (1.5 mg/kg), GTN (2 mcg/kg), labetalol (10 mg titrate up to 1 mg/kg), lignocaine (1–1.5 mg/kg given 2–3 min before laryngoscopy) or remifentanil (1 mcg/kg). 32 If remifentanil is used for GA induction, it is important to warn the attending neonatologist regarding possible transient neonatal respiratory depression. 33…”

Section: Cs-related Emergenciesmentioning

confidence: 99%

Peri-operative management of caesarean section for the occasional obstetric anaesthetist – an aide memoire

Lie

Mok

2017

Proceedings of Singapore Healthcare

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Anaesthesia practice for caesarean section (CS) has evolved in the past 20 years. This article aims to update occasional obstetric anaesthesiologists, obstetricians and clinicians involved in the management of pregnant women on the latest guidelines and recommendations for anaesthesia management, including pre-operative evaluation, informed consent, intra-operative and postoperative management for CS. In addition, this article will also summarise the management of CS associated emergencies such as difficult intubation, obstetric major postpartum haemorrhage, local anaesthetic toxicity and (pre-) eclampsia. At the end of the article, a charted summary will be provided as an aide memoire.

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Prevention of Peri-Induction Hypertension in Preeclamptic Patients

Cited by 3 publications

References 0 publications

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Effect on Neonatal Outcome of Pharmacological Interventions for Attenuation of the Maternal Haemodynamic Response to Tracheal Intubation: A Systematic Review

Peri-operative management of caesarean section for the occasional obstetric anaesthetist – an aide memoire

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