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Caesarean section in isobaric spinal anesthesia with and without direct preoperative hydration with crystalloids.
Bratisl Lek Listy. 2011; 112(8):459-62.BL

Abstract

BACKGROUND

Because the direct preoperative hydration with crystalloids (20 ml/kg) does not adequately prevent spinal hypotension during cesarean section, the authors investigated whether a continuous intravenous infusion of ephedrine (50 mg/500 ml of Ringer solution) without preoperative hydration would prevent the spinal hypotension more effectively.

METHODS

Forty parturients with ASA status I were randomized either to receive a preoperative hydration with 20 ml/kg of Ringer solution, or to receive continuous ephedrine infusion, simultaneously with spinal anesthesia. The infusion rate was adjusted according to systolic blood pressure. Significant hypotension was defined as a systolic blood pressure below 100 mmHg. Rescue boluses consisted of ephedrine 10 mg in parturients with prehydration and ephedrine 5 mg in parturients with ephedrine infusion.

RESULTS

Significant hypotension occurred less frequently in the ephedrine group than in the volume group: 40% versus 60% (p < 0.05). Nausea and vomiting occurred less frequently in the ephedrine group than in the volume group: 40% and 30% versus 60% and 50%, respectively (p < 0.05). The mean quantity of infused Ringer solution was 370 ml +/- 31 in the ephedrine group, i.e. significantly lower than 1,640 ml +/- 192 in the volume group (p < 0.05). The mean quantity of ephedrine given in the ephedrine group was 30 mg +/- 4.1. The mean quantity of ephedrine given in the volume group was 25 mg +/- 2. The difference was not significant. Apgar scores were similarly good in both groups.

CONCLUSION

The continuous infusion of ephedrine simultaneously with spinal anesthesia is superior to direct preoperative hydration with crystalloids in preventing the spinal hypotension and its clinical manifestations in parturients delivered with C-section (Tab. 3, Ref. 20).

Authors+Show Affiliations

Department of Anesthesiology, Reanimatology and Intensive medicine, Clinical Hospital Dr Trifun Panovski, Bitola, R. Macedonia. genadamevski@gmail.comNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info available

Pub Type(s)

Journal Article
Randomized Controlled Trial

Language

eng

PubMed ID

21863617

Citation

Damevski, V, et al. "Caesarean Section in Isobaric Spinal Anesthesia With and Without Direct Preoperative Hydration With Crystalloids." Bratislavske Lekarske Listy, vol. 112, no. 8, 2011, pp. 459-62.
Damevski V, Damevska G, Krivasija M, et al. Caesarean section in isobaric spinal anesthesia with and without direct preoperative hydration with crystalloids. Bratisl Lek Listy. 2011;112(8):459-62.
Damevski, V., Damevska, G., Krivasija, M., Nojkov, O., & Sivevski, A. (2011). Caesarean section in isobaric spinal anesthesia with and without direct preoperative hydration with crystalloids. Bratislavske Lekarske Listy, 112(8), 459-62.
Damevski V, et al. Caesarean Section in Isobaric Spinal Anesthesia With and Without Direct Preoperative Hydration With Crystalloids. Bratisl Lek Listy. 2011;112(8):459-62. PubMed PMID: 21863617.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Caesarean section in isobaric spinal anesthesia with and without direct preoperative hydration with crystalloids. AU - Damevski,V, AU - Damevska,G, AU - Krivasija,M, AU - Nojkov,O, AU - Sivevski,A, PY - 2011/8/26/entrez PY - 2011/8/26/pubmed PY - 2011/9/16/medline SP - 459 EP - 62 JF - Bratislavske lekarske listy JO - Bratisl Lek Listy VL - 112 IS - 8 N2 - BACKGROUND: Because the direct preoperative hydration with crystalloids (20 ml/kg) does not adequately prevent spinal hypotension during cesarean section, the authors investigated whether a continuous intravenous infusion of ephedrine (50 mg/500 ml of Ringer solution) without preoperative hydration would prevent the spinal hypotension more effectively. METHODS: Forty parturients with ASA status I were randomized either to receive a preoperative hydration with 20 ml/kg of Ringer solution, or to receive continuous ephedrine infusion, simultaneously with spinal anesthesia. The infusion rate was adjusted according to systolic blood pressure. Significant hypotension was defined as a systolic blood pressure below 100 mmHg. Rescue boluses consisted of ephedrine 10 mg in parturients with prehydration and ephedrine 5 mg in parturients with ephedrine infusion. RESULTS: Significant hypotension occurred less frequently in the ephedrine group than in the volume group: 40% versus 60% (p < 0.05). Nausea and vomiting occurred less frequently in the ephedrine group than in the volume group: 40% and 30% versus 60% and 50%, respectively (p < 0.05). The mean quantity of infused Ringer solution was 370 ml +/- 31 in the ephedrine group, i.e. significantly lower than 1,640 ml +/- 192 in the volume group (p < 0.05). The mean quantity of ephedrine given in the ephedrine group was 30 mg +/- 4.1. The mean quantity of ephedrine given in the volume group was 25 mg +/- 2. The difference was not significant. Apgar scores were similarly good in both groups. CONCLUSION: The continuous infusion of ephedrine simultaneously with spinal anesthesia is superior to direct preoperative hydration with crystalloids in preventing the spinal hypotension and its clinical manifestations in parturients delivered with C-section (Tab. 3, Ref. 20). SN - 0006-9248 UR - https://www.unboundmedicine.com/medline/citation/21863617/Caesarean_section_in_isobaric_spinal_anesthesia_with_and_without_direct_preoperative_hydration_with_crystalloids_ L2 - http://www.aepress.sk/_downloads/dl.php?from=pubmed&amp;journal=BLL&amp;file=2011_08_459.pdf DB - PRIME DP - Unbound Medicine ER -