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[Optimization of the neuroautonomic inhibition and regulation of hemodynamics during subarachnoid anesthesia in abdominal delivery].
Anesteziol Reanimatol. 2010 Nov-DecAR

Abstract

Pregnancy is considered in the spotlight of creation of general adaptation syndrome. It was revealed that 85% and 58% of healthy non-pregnant women had an inadequate autonomous nervous system (ANS) and circulatory system response respectively. This favoured the labour activity malfunction in 20% of women in childbirth when an abdominal delivery was needed. A traditional subarachnoid anesthesia (SA) in control group was accompanied by decrease of blood pressure (BP) to the numbers requiring a medicamentous correction (as by literature data). However, the central haemodynamics measures has shown a normal blood flow and the blood pressure correction was not performed. During surgery and in early post-operative period in all women in this group a parasympathetic tone has prevailed over, and the cardiac output was at the lower limit of the hypokinetic type of haemodynamics, which was accompanied with nausea and vomiting in 30% of women. Including the atropine administration into the traditional protocol of SA in cesarean section in pregnant patients with eu- and parasympathotonia (research group) has favoured the optimization of the neurovegetative inhibition of reflexes and stabilization of haemodynamics within the physiological ranges. Vagosympathetic block has been accompanied by sympathotonia with a lesser BP decrease compared to control group, absence of bradycardia, nausea and vomiting. Thus the BP can not serve as a criterion of the perfusion of essential organs, including uteroplacental haemodynamics, especially non-invasibe BP. Including the control of ANS tone dynamics, central haemodynamics and oxygen transport into monitoring guidelines in neuroaxial anaesthesia in abdominal delivery is necessary.

Authors

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Pub Type(s)

English Abstract
Journal Article
Randomized Controlled Trial

Language

rus

PubMed ID

21400791

Citation

Gur'ianov, V A., et al. "[Optimization of the Neuroautonomic Inhibition and Regulation of Hemodynamics During Subarachnoid Anesthesia in Abdominal Delivery]." Anesteziologiia I Reanimatologiia, 2010, pp. 17-22.
Gur'ianov VA, Tolmachev GN, Volodin AV, et al. [Optimization of the neuroautonomic inhibition and regulation of hemodynamics during subarachnoid anesthesia in abdominal delivery]. Anesteziol Reanimatol. 2010.
Gur'ianov, V. A., Tolmachev, G. N., Volodin, A. V., Marichik, N. V., & Nemirovskiĭ, V. B. (2010). [Optimization of the neuroautonomic inhibition and regulation of hemodynamics during subarachnoid anesthesia in abdominal delivery]. Anesteziologiia I Reanimatologiia, (6), 17-22.
Gur'ianov VA, et al. [Optimization of the Neuroautonomic Inhibition and Regulation of Hemodynamics During Subarachnoid Anesthesia in Abdominal Delivery]. Anesteziol Reanimatol. 2010 Nov-Dec;(6)17-22. PubMed PMID: 21400791.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - [Optimization of the neuroautonomic inhibition and regulation of hemodynamics during subarachnoid anesthesia in abdominal delivery]. AU - Gur'ianov,V A, AU - Tolmachev,G N, AU - Volodin,A V, AU - Marichik,N V, AU - Nemirovskiĭ,V B, PY - 2011/3/16/entrez PY - 2011/3/16/pubmed PY - 2011/4/9/medline SP - 17 EP - 22 JF - Anesteziologiia i reanimatologiia JO - Anesteziol Reanimatol IS - 6 N2 - Pregnancy is considered in the spotlight of creation of general adaptation syndrome. It was revealed that 85% and 58% of healthy non-pregnant women had an inadequate autonomous nervous system (ANS) and circulatory system response respectively. This favoured the labour activity malfunction in 20% of women in childbirth when an abdominal delivery was needed. A traditional subarachnoid anesthesia (SA) in control group was accompanied by decrease of blood pressure (BP) to the numbers requiring a medicamentous correction (as by literature data). However, the central haemodynamics measures has shown a normal blood flow and the blood pressure correction was not performed. During surgery and in early post-operative period in all women in this group a parasympathetic tone has prevailed over, and the cardiac output was at the lower limit of the hypokinetic type of haemodynamics, which was accompanied with nausea and vomiting in 30% of women. Including the atropine administration into the traditional protocol of SA in cesarean section in pregnant patients with eu- and parasympathotonia (research group) has favoured the optimization of the neurovegetative inhibition of reflexes and stabilization of haemodynamics within the physiological ranges. Vagosympathetic block has been accompanied by sympathotonia with a lesser BP decrease compared to control group, absence of bradycardia, nausea and vomiting. Thus the BP can not serve as a criterion of the perfusion of essential organs, including uteroplacental haemodynamics, especially non-invasibe BP. Including the control of ANS tone dynamics, central haemodynamics and oxygen transport into monitoring guidelines in neuroaxial anaesthesia in abdominal delivery is necessary. SN - 0201-7563 UR - https://www.unboundmedicine.com/medline/citation/21400791/[Optimization_of_the_neuroautonomic_inhibition_and_regulation_of_hemodynamics_during_subarachnoid_anesthesia_in_abdominal_delivery]_ L2 - https://medlineplus.gov/cesareansection.html DB - PRIME DP - Unbound Medicine ER -