Spinal anesthesia for lower segment Cesarean section in patients with stable eclampsia

Singh, Ranju; Kumar, Nishant; Jain, Aparna; Chakraborty, Madhurima

doi:10.1016/j.jclinane.2010.08.011

Cited by 9 publications

(14 citation statements)

References 41 publications

(56 reference statements)

Supporting

Mentioning

Contrasting

Order By: Relevance

“…We also did not have difficult or failed spinal anaesthesia. This finding was in support of findings of Singh et al and Basu et al who had no difficult or failed spinal anaesthesia amongst the eclamptic patients who had spinal aneasthesia [ 5 , 6 ]. The procedure which was performed by a consultant anaesthetist was not associated with any form of difficulty in passing spinal needle nor spinal haematoma.…”

Section: Discussionsupporting

confidence: 90%

“…General anaesthesia would have been a technique of choice in this patient with unstable eclampsia, but the presence of features suggestive of difficult airway did not favour it. In the face of difficult intubation, the attendant hypoxia (desaturation), aspiration pneumonitist, aggravated laryngeal oedema, pressor response to laryngoscopic and intubation can be exaggerated in this eclamptic parturient [ 5 , 6 ]. Although Mallampati assessment could not be carried out, the patient has short neck, large and swollen tongue and more swollen face due to significant tissue edema.…”

Section: Discussionmentioning

confidence: 99%

“…Spinal anaesthesia in stable eclampsia is no longer new [ 1 – 6 ]. Eclampsia is said to be unstable if there are associated complications such as thrombocytopenia, raised intra cranial pressure, uncontrollable convulsions, restlessness, fetal distress, unconsciousness (GCS < 9), respiratory failure and haemorrhage [ 4 , 5 ]. Studies have demonstrated some benefits of sub-arachnoid block over general anaesthesia in stable eclamptic [ 1 , 2 , 4 – 6 ].…”

Section: Introductionmentioning

confidence: 99%

See 2 more Smart Citations

Spinal anaesthesia in a restless eclamptic with undiagnosed second twin: case report

Afolayan¹,

Olofinbiyi²,

Ipinnimo³

2015

Pan Afr Med J

View full text Add to dashboard Cite

The use of sub-arachnoid block in a restless eclamptic is not very common. Studies have demonstrated some benefits of sub-arachnoid block over general anaesthesia in stable eclamptic but its role in the management of unstable eclampsia has not been established. Reported below is an eclamptic parturient who was restless despite magnesium sulphate regimen and possesed features suggestive of difficult airway who had uneventful subarachnoid- block for caesarean section.

show abstract

Section: Discussionsupporting

confidence: 90%

Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

See 1 more Smart Citation

Spinal anaesthesia in a restless eclamptic with undiagnosed second twin: case report

Afolayan¹,

Olofinbiyi²,

Ipinnimo³

2015

Pan Afr Med J

View full text Add to dashboard Cite

show abstract

“…[ 3 ] Major maternal complications associated with HDP are placental abruption, hemolysis, elevated liver enzymes, low platelets syndrome, disseminated intravascular coagulation, neurologic deficits, pulmonary edema and acute renal failure. [ 4 ] Widespread endothelial dysfunction can also occur in the placenta that ultimately leads to placental ischemic injury or even infarction. [ 5 ]…”

Section: Introductionmentioning

confidence: 99%

Goal-directed Fluid Therapy May Improve Hemodynamic Stability of Parturient with Hypertensive Disorders of Pregnancy Under Combined Spinal Epidural Anesthesia for Cesarean Delivery and the Well-being of Newborns

Xiao

Duan

et al. 2015

Chinese Medical Journal

View full text Add to dashboard Cite

Background:Hypotension induced by combined spinal epidural anesthesia in parturient with hypertensive disorders of pregnancy (HDP) can easily compromise blood supply to vital organs including uteroplacental perfusion and result in fetal distress. The aim of this study was to investigate whether the goal-directed fluid therapy (GDFT) with LiDCOrapid system can improve well-being of both HDP parturient and their babies.Methods:Fifty-two stable HDP parturient scheduled for elective cesarean delivery were recruited. After loading with 10 ml/kg lactated Ringer's solution (LR), parturient were randomized to the GDFT and control group. In the GDFT group, individualized fluid therapy was guided by increase in stroke volume (ΔSV) provided via LiDCOrapid system. The control group received the routine fluid therapy. The primary endpoints included maternal hypotension and the doses of vasopressors administered prior to fetal delivery. The secondary endpoints included umbilical blood gas abnormalities and neonatal adverse events.Results:The severity of HDP was similar between two groups. The total LR infusion (P < 0.01) and urine output (P < 0.05) were higher in the GDFT group than in the control group. Following twice fluid challenge tests, the systolic blood pressure, mean blood pressure, cardiac output and SV in the GDFT group were significantly higher, and the heart rate was lower than in the control group. The incidence of maternal hypotension and doses of phenylephrine used prior to fetal delivery were significantly higher in the control group than in the GDFT group (P < 0.01). There were no differences in the Apgar scores between two groups. In the control group, the mean values of pH in umbilical artery/vein were remarkably decreased (P < 0.05), and the incidences of neonatal hypercapnia and hypoxemia were statistically increased (P < 0.05) than in the GDFT group.Conclusions:Dynamic responsiveness guided fluid therapy with the LiDCOrapid system may provide potential benefits to stable HDP parturient and their babies.

show abstract

“…Other advantages of spinal compared to epidural anesthesia are its more rapid onset, its better intraoperative analgesic effects, and the fact that it can be carried out in the presence of moderate thrombocytopenia when epidural technique is contraindicated. Epidural tap also has a higher risk of cerebral herniation [ 27 ]. In Case 2, neither hypotension nor bradycardia occurred with the use of spinal anaesthesia despite the concomitant infusion of magnesium and of antihypertensive drugs.…”

Section: Discussionmentioning

confidence: 99%

Management of Posterior Reversible Syndrome in Preeclamptic Women

Poma

Delmonte

Gigliuto

et al. 2014

Case Reports in Obstetrics and Gynecology

View full text Add to dashboard Cite

Posterior reversible encephalopathy syndrome (PRES) is a neurological syndrome associated with a number of conditions including preeclampsia. It is characterized by seizures, alteration of consciousness, visual disturbances, and symmetric white matter abnormalities, typically in the posterior parietooccipital regions of the cerebral hemispheres, at computed tomography (CT) and magnetic resonance (MRI). We report three new cases of PRES in preeclamptic patients and describe the management of these patients. We present a brief review of other cases in the literature, with particular attention to the anesthetic management.

show abstract

Spinal anesthesia for lower segment Cesarean section in patients with stable eclampsia

Cited by 9 publications

References 41 publications

Spinal anaesthesia in a restless eclamptic with undiagnosed second twin: case report

Spinal anaesthesia in a restless eclamptic with undiagnosed second twin: case report

Goal-directed Fluid Therapy May Improve Hemodynamic Stability of Parturient with Hypertensive Disorders of Pregnancy Under Combined Spinal Epidural Anesthesia for Cesarean Delivery and the Well-being of Newborns

Management of Posterior Reversible Syndrome in Preeclamptic Women

Contact Info

Product

Resources

About