The impact of height on the spread of spinal anesthesia and stress response in parturients undergoing caesarean section: a prospective observational study

She, Ying-Jun; Liu, Wenxing; Ly, Wang; Ou, Xinxu; Liang, Huihong; Lei, Dong-Xu

doi:10.1186/s12871-021-01523-2

Cited by 10 publications

(7 citation statements)

References 41 publications

(57 reference statements)

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“…In comparison with it in Conventional group, the dose of bupivacaine in Test group was less, and the time to reach adequate anesthesia was later (Table 4). This is supported by other studies (30,42). However, the height based dosing algorithm of bupivacaine did not delay the operation duration, because the time to reach adequate anesthesia was 4.858 (1.521) min, which was approximate to the time of skin disinfection, placing sterile surgical drape and wearing sterile surgical clothes for surgeon.…”

Section: Height Based Dosing Algorithm Of Bupivacaine Provided Adequa...supporting

confidence: 67%

“…Therefore, the height based dosing algorithm of bupivacaine in this study is reasonable, especially using a low dose of bupivacaine (16,17). The height of parturient is associated with the block onset time (42) and block level (29), and is regarded as a risk factor for hypotension (29). However, in some studies, the variation in block spread of the subjects with same height is very large, the height does not influence the block level of spinal anesthesia (13,31).…”

Section: Dose Of Bupivacaine Depended On Heightmentioning

confidence: 86%

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A Height-Based Dosing Algorithm of Bupivacaine in Spinal Anesthesia for Decreasing Maternal Hypotension in Cesarean Section Without Prophylactic Fluid Preloading and Vasopressors: A Randomized-Controlled Non-Inferiority Trial

et al. 2022

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BackgroundThere is a high incidence of maternal hypotension in spinal anesthesia for cesarean section. The aim of the study is to investigate whether there is a height-based dosing algorithm of bupivacaine that provides adequate anesthesia with less maternal hypotension.MethodsThere were 2 groups of 280 parturients who did not receive prophylactic fluid preloading: Test and Conventional group. In Test group, a height based dosing algorithm was used to confirm the dose of bupivacaine in parturients without prophylactic vasopressors. In the Conventional group, a constant dose of bupivacaine was used. The complications and quality of anesthesia were evaluated.ResultsIn the Conventional group, the shorter participants had higher incidence of hypotension, faster sensory block time, and more participants with complete motor block (p = 0.030, 2.957 × 10−14, and 0.012). In the Test group, the incidence of hypotension, sensory block time, and number of participants with complete motor block did not change with height (p = 0.199, 0.617, and 0.209). The height-based dosing algorithm of bupivacaine decreased the incidence of hypotension (p = 0.004), induced lower sensory block level and less degree of motor block (p = 3.513 × 10−7 and 5.711 × 10−11). The quality of analgesia, quality of muscle relaxation, and degree of intraoperative comfort were similar in both groups (p = 0.065, 0.498, and 0.483).ConclusionsThe height influences the dose of bupivacaine in spinal anesthesia; without prophylactic fluid pre-loading and vasopressors, the height-based dosing algorithm of bupivacaine is suitable, and meets the cesarean section' requirement with less maternal hypotension.Clinical Trial Registrationwww.ClinicalTrials.gov, identifier: NCT03497364.

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Section: Height Based Dosing Algorithm Of Bupivacaine Provided Adequa...supporting

confidence: 67%

Section: Dose Of Bupivacaine Depended On Heightmentioning

confidence: 86%

A Height-Based Dosing Algorithm of Bupivacaine in Spinal Anesthesia for Decreasing Maternal Hypotension in Cesarean Section Without Prophylactic Fluid Preloading and Vasopressors: A Randomized-Controlled Non-Inferiority Trial

et al. 2022

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“…22 . Nevertheless this could also be considered a limitation of our study since as documented recently the most important factor in determining the spread of local anesthetic in the spinal canal was vertebral length and not patient height, 23 .…”

Section: Discussionmentioning

confidence: 89%

Failure of two different doses of ondansetron to prevent maternal hypotension in spinal anesthesia with ropivacaine 0.75% for cesarean section; a randomized, double blind trial.

Karachanidi¹

2023

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Introduction: Ondansetron, a selective 5-hydroxytryptamine 3 (5-HT3) receptor antagonist, commonly used as an antiemetic has been proven in recent studies to be effective for the prevention of spinalinduced hypotension for elective cesarean section. Methods:One hundred and thirty-eight healthy primigravida parturients scheduled for elective cesarean section were randomly assigned to three groups. Participants in the ONDA4, ONDA8, and CONTROL groups received 4 mg of ondansetron, 8 mg of ondansetron and normal saline respectively, 10 minutes before spinal anesthesia. Spinal anesthesia was performed at L3-L4 interspinous space, with 1.7 ml ropivacaine 0.75% and 15 mcg of fentanyl, via a 27 G pencil point needle. Blood pressure and heart rate were recorded upon arrival at the operating room, after preloading with 500 ml of 6% hydroxyethylstarch, at the time of spinal injection, and at oneminute intervals for 10 minutes thereafter. Blood pressure and heart rate values, total phenylephrine (mcg) or/and ephedrine (mg) doses, the incidence of maternal nausea/vomiting/shivering, umbilical artery pH and Apgar scores at 1 and 5 min were recorded. Time for the sensory block to reach T4 and regress to T7 dermatome, and the time for the motor block to reach Bromage scale 3 and to regress to Bromage scale 1, were also noted.Results: There were no differences between groups in hemodynamic parameters or doses of vasoactive agents used, sensory or motor block characteristics, incidence of nausea/vomiting, umbilical artery pH or Apgar scores of the neonates. Conclusion:Our results failed to demonstrate the significance of ondansetron in preventing maternal hypotension following spinal anesthesia for cesarian section.

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“…Dosis yang disesuaikan didukung oleh data hemodinamik yang menunjukkan bahwa waktu untuk mencapai tingkat sensorik yang sesuai untuk operasi berkorelasi dengan tinggi badan dan berbanding terbalik dengan berat badan. 9,10 Penelitian sebelumnya telah mengkonfirmasi bahwa tingkat akhir blok dapat diprediksi dengan tinggi dan berat badan pasien. 4 Dosis optimal akan memungkinkan penyebaran dermatomal tetapi dapat menghindari kejadian hipotensi ibu.…”

Section: Pendahululanunclassified

Anestesi Spinal untuk Seksio Sesarea Pasien dengan Tinggi Badan Ekstrim Pendek

Bisri

2023

JAOI

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Anestesi untuk seksio sesarea dapat dilakukan dengan anestesi spinal, epidural, combined spinal-epidural atau anestesi umum. Akan tetapi, pilihan utama anestesi untuk seksio sesarea adalah anestesi spinal karena murah, mudah dilakukan, cepat bekerja dan risiko aspirasi tidak ada serta tidak ada masalah pengelolaan jalan nafas. Masalah utama spinal anestesi adalah adanya hipotensi, mual muntah intraoperatif, postdural puncture headache (PDPH), dan merupakan kontraindikasi bila dilakukan pada orang dengan ekstrim pendek karena ketakutan terjadi hipotensi berat. Dua orang wanita gravida aterm ekstrim pendek, dilakukan seksio sesarea (SC) dengan anestesi spinal di Rumah Sakit Melinda Bandung. Pasien pertama dengan berat badan 61 kg, tinggi badan 145 cm, pasien kedua dengan berat badan 64 kg, tinggi badan 146 cm. Keduanya dilakukan spinal anestesi dengan bupivacain hiperbarik 0,5%, ditambah fentanyl dan morfin. Pengaturan dosis bupivacain berdasarkan kombinasi berat badan dan tinggi badan. Tidak ada kejadian penurunan tekanan darah >20% dari tekanan darah awal pada kedua pasien tersebut.

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The impact of height on the spread of spinal anesthesia and stress response in parturients undergoing caesarean section: a prospective observational study

Cited by 10 publications

References 41 publications

A Height-Based Dosing Algorithm of Bupivacaine in Spinal Anesthesia for Decreasing Maternal Hypotension in Cesarean Section Without Prophylactic Fluid Preloading and Vasopressors: A Randomized-Controlled Non-Inferiority Trial

A Height-Based Dosing Algorithm of Bupivacaine in Spinal Anesthesia for Decreasing Maternal Hypotension in Cesarean Section Without Prophylactic Fluid Preloading and Vasopressors: A Randomized-Controlled Non-Inferiority Trial

Failure of two different doses of ondansetron to prevent maternal hypotension in spinal anesthesia with ropivacaine 0.75% for cesarean section; a randomized, double blind trial.

Anestesi Spinal untuk Seksio Sesarea Pasien dengan Tinggi Badan Ekstrim Pendek

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