Prophylactic Intravenous Ephedrine Infusion During Spinal Anesthesia for Cesarean Section

Kang, Yoogoo; Abouleish, Ezzat; Caritis, Steve N.; Gutsche, Brett B.; Cheek, Theodore G.

doi:10.1097/00132586-198310000-00051

Cited by 60 publications

(57 citation statements)

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“…Intravenous administration appears to be the optimal route, and it seems that in the obstetric patient, at least, there is much to be gained from preventing hypotension in terms of maternal well-being 76 and neonatal acid-base status. 76,77 This appears to be better achieved by the use of an ephedrine infusion immediately after siting the spinal block. 77 The use of a prophylactic infusion of ephedrine may be useful in nonobstetric practice when a large fluid load may be undesirable, 78 but this needs further investigation.…”

Section: How Should the Vasopressor Be Administered?mentioning

confidence: 99%

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The role of vasopressors in the management of hypotension induced by spinal and epidural anaesthesia

Morgan

1994

Can J Anaesth

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Section: How Should the Vasopressor Be Administered?mentioning

confidence: 99%

“…76,77 This appears to be better achieved by the use of an ephedrine infusion immediately after siting the spinal block. 77 The use of a prophylactic infusion of ephedrine may be useful in nonobstetric practice when a large fluid load may be undesirable, 78 but this needs further investigation.…”

Section: How Should the Vasopressor Be Administered?mentioning

confidence: 99%

The role of vasopressors in the management of hypotension induced by spinal and epidural anaesthesia

Morgan

1994

Can J Anaesth

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“…The administration of LMWH to neurosurgical patients [9,34] and high-risk trauma patients with major head injury [17] is a safe and effective method of reducing the incidence of venous thromboembolism without inducing any significant increase of major bleeding. Agnelli et al…”

Section: Discussionmentioning

confidence: 99%

“…Ephedrine is more conventionally given intravenously. Bolus intravenous doses have been compared to intravenous infusions, with infusions proving more effective at keeping maternal pressure closer to baseline values [17]. Furthermore, it has been demonstrated that rather than waiting for a predetermined level of hypotension to develop, the immediate treatment of any reduction in blood pressure with ephedrine prevents its further decline.…”

Section: Discussionmentioning

confidence: 99%

“…Inappropriate use of these methods, because of the nature or site of the injuries, may lead to a failure of DVT prophylaxis. An effective alternative to anticoagulation may be vena caval interruption [14,15].There is increasing evidence that the use of low-dose unfractionated heparin and the newer low-molecularweight heparins (LMWH) in neurosurgical patients results in a clinically significant decrease in venous thromboembolism without inducing any significant increase of major bleeding [9,10,16,17]. However, anecdotal evidence suggests that most surgeons and anaesthetists intentionally avoid the use of heparin prophylaxis in this subgroup of patients.…”

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confidence: 99%

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Anaesthesia for insertion of bone‐anchored hearing aids in children: a 7‐year audit

Jones¹,

Dickson

Moriarty³

2001

Anaesthesia

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SummaryForty-three children, aged 23 months to 14 years, received 102 anaesthetics for insertion of boneanchored hearing aids, each lasting approximately 30±60 min. Forty of the children had a recognised syndrome involving the head and neck, including Goldenhar's and Treacher Collin's syndrome. The incidence of congenital heart disease was 19%. Pre-existing conditions, anaesthetic technique, grade of intubation, complications and discharge were audited. Sixteen of the patients were classified as Grade 3 or 4 intubations. Over the 7 years, laryngeal mask airway usage increased for airway maintenance rather than tracheal intubation, as did the use of propofol for induction rather than inhalational methods. Intra-operative complications (5.9%) were related to the airway, and postoperative ones (17.6%) mainly to nausea and vomiting. Surgery was performed as a day case in 71% of the patients despite some long-distance travel. Children with conductive deafness are usually fitted with conventional hearing aids at an early age. This is impossible in children with congenital absence of the ears or external auditory canals, and in those with a chronic suppurative discharge.Unilateral microtia may be associated with various malformations involving the first and second branchial arch such as Goldenhar's syndrome (oculoauricularvertebral syndrome) [1]; 20% of children with Goldenhar's syndrome also have congenital heart disease. Bilateral microtia is often associated with Treacher Collin's syndrome (mandibular dysostosis) along with micrognathia, aplastic zygomatic arches, microstomia and choanal atresia [2]. Abnormalities of the auditory canals are sporadically found among children with other craniofacial and musculoskeletal abnormalities.The fitting of a bone-anchored hearing aid (BAHA) in these children, especially if performed early, allows them to hear and develop normal speech. BAHAs rely on osseointegration, which is defined as direct contact between living bone and a loaded implant surface. They were developed first in Sweden in 1977 [3] following earlier work involving fixation of missing teeth. The suitability of a patient to be fitted with a BAHA requires extensive multidisciplinary assessment. There should be maximal conductive hearing loss, and good cochlear reserve. A limiting factor is age as bone thickness may not be adequate before 2 years of age.The surgery involves two operations, each lasting 30± 60 min. The patient is supine with the head slightly raised and tilted to one side, supported by a sandbag. A titanium fixture, 3±4 mm in diameter, is implanted into the mastoid bone behind the ear. Frequently, two are inserted to allow for failure or traumatic loss. After 3±6 months, osseointegration should have occurred and at the second operation the skin flap over the implant is thinned and an abutment, designed to carry the hearing aid, is placed over the fixture. After healing, the hearing aid is fitted in outpatients. The overall failure rate, with two fixtures, in Birmingham is 8% [4]. 777BAHA surgery w...

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Techniques for preventing hypotension during spinal anaesthesia for caesarean section

Chooi

Cox

Lumb

et al. 2017

Cochrane Database of Systematic Reviews

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Prophylactic Intravenous Ephedrine Infusion During Spinal Anesthesia for Cesarean Section

Cited by 60 publications

References 0 publications

The role of vasopressors in the management of hypotension induced by spinal and epidural anaesthesia

The role of vasopressors in the management of hypotension induced by spinal and epidural anaesthesia

Anaesthesia for insertion of bone‐anchored hearing aids in children: a 7‐year audit

Techniques for preventing hypotension during spinal anaesthesia for caesarean section

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