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
Related Articles
- EP ID EP465337
- DOI 10.21088/ijaa.2349.8471.4217.21
- Views 90
- Downloads 0
Effect of Low Dose Magnesium Sulphate on Succinylcholine Induced Fasciculations & Postoperative Myalgia
Objectives: To investigate the effect of Magnesium Sulphate on Succinylcholine induced fasciculations during General Anaesthesia & postoperative myalgia. Methods: Double blind randomised clinical trial on patients who we...
A Comparative Study of Post Operative Side Effects between Spinal Bupivacaine Plus Buprenorphine and Combined Femoral and Sciatic Nerve Block Plus Spinal Bupivacaine Used for Analgesia
Aim and objective: The aim of this study was to compare postoperative side effects produced by spinal bupivacaine plus buprenorphine with femoral and sciatic nerve blocks plus spinal bupivacaine. Settings and Design: Ran...
Effects of Dexamethasone as a Local Anaesthetic Adjuvant for Ultrasound Guided Brachial Plexus Block: A Prospective, Randomised, Double Blind Study
Backgruond: Dexamethasone as an adjuvant in brachial plexus block has been reported to prolong the duration of action of local anesthetic. We performed a prospective, randomised, double blind study to evaluate the effect...
An Evaluation of Depth of Epidural Space by Ultrasound in Thoracic Epidural via Paramedian Approach
The insertion of the epidural catheter at the thoracic spine is technically more difficult and can cause neurological complications. The ultrasound prepuncture knowledge of the distance from the skin to the extradural sp...
Four Segments Versus two Segments Paravertebral Block for Inguinal Hernia Repair
Background: Paravertebral block (PVB) has been successfully used to provide good analgesia with fewer side effects in inguinal herniorrhaphy. So, the present study was conducted to compare the characteristics of two segm...