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Assessment of an updated double-vasopressor automated system using Nexfin for the maintenance of haemodynamic stability to improve peri-operative outcome during spinal anaesthesia for caesarean section.
Anaesthesia 2015; 70(6):691-8A

Abstract

Hypotension occurs commonly during spinal anaesthesia for caesarean section, associated with maternal and fetal adverse effects. We developed a double-vasopressor automated system with a two-step algorithm and continuous non-invasive haemodynamic monitoring using the Nexfin device. The system delivered 25 μg phenylephrine every 30 s when systolic blood pressure was between 90% and 100% of baseline, or 2 mg ephedrine at this blood pressure range and heart rate < 60 beats.min(-1) ; and 50 μg phenylephrine or 4 mg ephedrine when systolic blood pressure was < 90% of baseline with the same heart rate criterion. Fifty-seven women received standardised spinal anaesthesia. Twenty-seven (47.4%) had at least one reading of hypotension defined as systolic blood pressure < 80% baseline. Systolic blood pressure was within 20% of the baseline in a mean (SD) of 79.8 (20.9)% of measurements. Fifty-three (93.0%) women required phenylephrine before delivery while 10 (17.5%) required ephedrine. Six women (10.5%) experienced nausea and three (5.3%) vomited. The system was able to achieve a low incidence of maternal hypotension with good maternal and fetal outcomes.

Authors+Show Affiliations

Department of Women's Anaesthesia, KK Women's and Children's Hospital, Singapore. Centre for Quantitative Medicine, Duke-NUS Graduate Medical School, Singapore.Centre for Quantitative Medicine, Duke-NUS Graduate Medical School, Singapore.Centre for Quantitative Medicine, Duke-NUS Graduate Medical School, Singapore. Singapore Clinical Research Institute, Singapore.Department of Women's Anaesthesia, KK Women's and Children's Hospital, Singapore. Duke-NUS Graduate Medical School, Singapore.

Pub Type(s)

Journal Article
Research Support, Non-U.S. Gov't

Language

eng

PubMed ID

25627651

Citation

Sng, B L., et al. "Assessment of an Updated Double-vasopressor Automated System Using Nexfin for the Maintenance of Haemodynamic Stability to Improve Peri-operative Outcome During Spinal Anaesthesia for Caesarean Section." Anaesthesia, vol. 70, no. 6, 2015, pp. 691-8.
Sng BL, Wang H, Assam PN, et al. Assessment of an updated double-vasopressor automated system using Nexfin for the maintenance of haemodynamic stability to improve peri-operative outcome during spinal anaesthesia for caesarean section. Anaesthesia. 2015;70(6):691-8.
Sng, B. L., Wang, H., Assam, P. N., & Sia, A. T. (2015). Assessment of an updated double-vasopressor automated system using Nexfin for the maintenance of haemodynamic stability to improve peri-operative outcome during spinal anaesthesia for caesarean section. Anaesthesia, 70(6), pp. 691-8. doi:10.1111/anae.13008.
Sng BL, et al. Assessment of an Updated Double-vasopressor Automated System Using Nexfin for the Maintenance of Haemodynamic Stability to Improve Peri-operative Outcome During Spinal Anaesthesia for Caesarean Section. Anaesthesia. 2015;70(6):691-8. PubMed PMID: 25627651.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Assessment of an updated double-vasopressor automated system using Nexfin for the maintenance of haemodynamic stability to improve peri-operative outcome during spinal anaesthesia for caesarean section. AU - Sng,B L, AU - Wang,H, AU - Assam,P N, AU - Sia,A T, Y1 - 2015/01/28/ PY - 2014/12/07/accepted PY - 2015/1/29/entrez PY - 2015/1/30/pubmed PY - 2015/7/22/medline SP - 691 EP - 8 JF - Anaesthesia JO - Anaesthesia VL - 70 IS - 6 N2 - Hypotension occurs commonly during spinal anaesthesia for caesarean section, associated with maternal and fetal adverse effects. We developed a double-vasopressor automated system with a two-step algorithm and continuous non-invasive haemodynamic monitoring using the Nexfin device. The system delivered 25 μg phenylephrine every 30 s when systolic blood pressure was between 90% and 100% of baseline, or 2 mg ephedrine at this blood pressure range and heart rate < 60 beats.min(-1) ; and 50 μg phenylephrine or 4 mg ephedrine when systolic blood pressure was < 90% of baseline with the same heart rate criterion. Fifty-seven women received standardised spinal anaesthesia. Twenty-seven (47.4%) had at least one reading of hypotension defined as systolic blood pressure < 80% baseline. Systolic blood pressure was within 20% of the baseline in a mean (SD) of 79.8 (20.9)% of measurements. Fifty-three (93.0%) women required phenylephrine before delivery while 10 (17.5%) required ephedrine. Six women (10.5%) experienced nausea and three (5.3%) vomited. The system was able to achieve a low incidence of maternal hypotension with good maternal and fetal outcomes. SN - 1365-2044 UR - https://www.unboundmedicine.com/medline/citation/25627651/Assessment_of_an_updated_double_vasopressor_automated_system_using_Nexfin_for_the_maintenance_of_haemodynamic_stability_to_improve_peri_operative_outcome_during_spinal_anaesthesia_for_caesarean_section_ L2 - https://doi.org/10.1111/anae.13008 DB - PRIME DP - Unbound Medicine ER -