Comparison of Hemodynamic Response and Vasopressor Requirement Following Spinal Anaesthesia, between Normotensive and Mild Gestational Hypertension Patients Undergoing Caesarean Section: A Prospective Study
Journal Title: Indian Journal of Anesthesia and Analgesia - Year 2017, Vol 4, Issue 2
Abstract
Background: Neuraxial anaesthesia is the preferred anaesthesia technique for delivery by caesarean section. Despite controversies, there is evidence that supports the use of spinal anaesthesia in severe preeclampisa group. Present evidence suggests that gestational hypertension and preeclamsia are distinct entities, however very few attempts are made to study the hemodynamic changes and vasopressor requirement in mild gestational hypertension parturients following spinal anaesthesia for caesarean delivery. The aim of the present study was to compare heart rate, systolic blood pressure, diastolic blood pressure, mean arterial pressure, Mephenteramine requirement and neonatal outcome between normotensive and mild gestational hypertension parturients undergoing caesarean delivery under spinal anaesthesia. Materials and Methods: A total of 60 parturients not in labour, scheduled for elective caesarean section, meeting inclusion criteria, were included in the study, 30 were in normotensive group and 30 were in mild gestational hypertension group, with blood pressure <160/ 110mm hg. Spinal anaesthesia was administered using 2.2ml of 0.5% hyperbaric Bupivacaine (Heavy). Baseline hemodynamic parameters were recorded before spinal anesthesia and then at every 2 minute interval after spinal block for the first 30 minutes and thereafter every 5 minutes until completion of surgery. Hypotension was defined as, more than 30% of decline in mean arterial pressure compared to baseline in both groups (or systolic blood pressure <100 mmHg in healthy parturients) and was treated with injection Mephenteramine, 5mg bolus intravenously, Apgar score was noted at 1 and 5 minutes after birth. Results: The minimum systolic blood pressure, mean arterial pressure and heartrate recorded were lower in normotensives but the difference between the two groups was not statistically significant. The average Mephenteramine requirement in normotensive group (8.5 mg) was slightly more than in mild gestational hypertension (8.25mg) group. Apgar scores at 1 and 5 minutes after birth were comparable in both the groups. Conclusion: Hemodynamic response and vasopressor requirement following spinal anesthesia in mild gestational hypertension group was similar to normotensive group with comparable Apgar scores.
Authors and Affiliations
Kakhandki Srinivas
Keywords
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- EP ID EP465337
- DOI 10.21088/ijaa.2349.8471.4217.21
- Views 92
- Downloads 0
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