Fluid management in obstetric anesthesia
Journal Title: Ελληνικό ηλεκτρονικό Περιοδικό Περιεγχειρητικής Ιατρικής - Year 2018, Vol 17, Issue 0
Abstract
Current evidence suggests that the combination of fluid administration and vasoconstrictive medications should be the main strategy for prevention and management of hypotension accompanying neuraxial anesthesia procedures during cesarean section. Research is still underway in relation to the most appropriate timing for fluid administration, the most appropriate fluid volume as well as the type of fluid that should be administered. However, pre-loading of crystalloids seems to be inefficient as a sole strategy, while co-loading of colloids is more effective than co-loading of crystalloids for prevention of hypotension in the parturient. On the other hand, pre-loading and co-loading of colloids seem to be of equal effectiveness. It should also be emphasized that lower doses of spinal local anesthetics and early administration of phenylephrine are of value in the prevention and treatment of spinally induced hypotension. Gelatins and dextrans should be carefully administered due to serious untoward effects associated with their use while starches should be avoided when there is preexisting renal dysfunction, coagulation abnormalities or sepsis.
Authors and Affiliations
Kassiani Theodoraki
Keywords
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