A comparison between prophylactic IV ephedrine hydrochloride and crystalloid preloading for prevention of post-spinal hypotension

2020 ◽  
Vol 17 (1) ◽  
pp. 11-16
Author(s):  
Palakben Parikh ◽  
Keyword(s):  
Ephedrine Hydrochloride ◽  
Spinal Hypotension

scholarly journals Comparison of two Norepinephrine rescue bolus for Management of Post-spinal Hypotension during Cesarean Delivery: a randomized controlled trial

2020 ◽  
Vol 20 (1) ◽  
Author(s):  
Yasmin S. Hassabelnaby ◽  
Ahmed M. Hasanin ◽  
Nada Adly ◽  
Maha M. A. Mostafa ◽  
Sherin Refaat ◽  
...  
Keyword(s):  
Randomized Controlled Trial ◽  
Cesarean Delivery ◽  
Controlled Trial ◽  
Randomized Controlled ◽  
Spinal Hypotension

scholarly journals The transverse diameter of right common femoral vein by ultrasound in the supine position for predicting post-spinal hypotension during cesarean delivery

2021 ◽  
Vol 21 (1) ◽  
Author(s):  
Shi-Fa Yao ◽  
Yan-Hong Zhao ◽  
Jing Zheng ◽  
Jie-Yan Qian ◽  
Chen Zhang ◽  
...  
Keyword(s):  
Spinal Anesthesia ◽  
Cesarean Delivery ◽  
Femoral Vein ◽  
Elective Cesarean Section ◽  
Gravid Uterus ◽  
Transverse Diameter ◽  
Common Femoral Vein ◽  
Link Type ◽  
Spinal Hypotension ◽  
Receiver Operating

Abstract Background Post-spinal anesthesia hypotension during cesarean delivery is caused by decreased systemic vascular resistance due to the blockage of the autonomic nerves, which is further worsened by inferior vena cava (IVC) compression by the gravid uterus. This study aimed to assess whether peak velocity and diameter of the IVC below the xiphoid or right common femoral vein (RCFV) in the inguinal region, as measured on ultrasound, could reflect the degree of IVC compression and further identify parturients at risk of post-spinal hypotension. Methods Fifty-six parturients who underwent elective cesarean section with spinal anesthesia were included in this study; peak velocities and anteroposterior diameters of the IVC and peak velocities and transverse diameters of the RCFV were measured using ultrasound before anesthesia. The primary outcome was the ultrasound measurements of IVC and RCFV acquired before spinal anesthesia and their association with post-spinal hypotension. Hypotension was defined as a drop in systolic arterial pressure by > 20% from the baseline. Multinomial logistic regression analysis was used to identify the association between the measurements of IVC, RCFV, and post-spinal hypotension during cesarean delivery. Receiver operating characteristic curves were used to test the abilities of the identified parameters to predict post-spinal hypotension; the areas under the curve and optimum cut-off values for the predictive parameters were calculated. Results A longer transverse diameter of the RCFV was associated with the occurrence of post-spinal hypotension (odds ratio = 2.022, 95% confidence interval [CI] 1.261–3.243). The area under the receiver operating characteristics curve for the prediction of post-spinal hypotension was 0.759 (95% CI 0.628–0.890, P = 0.001). A transverse diameter of > 12.2 mm of the RCFV could predict post-spinal hypotension during cesarean delivery. Conclusions A longer transverse diameter of RCFV was associated with hypotension and could predict parturients at a major risk of hypotension before anesthesia. Trial registration This study was registered at http://www.chictr.org.cn on 16, May, 2018. No. ChiCTR1800016163.

PREVENTION OF SPINAL HYPOTENSION ASSOCIATED WITH CESAREAN SECTION

1977 ◽  
Vol 21 (5) ◽  
pp. 451???452
Author(s):  
R. B. CLARK ◽  
D. S. THOMPSON ◽  
C. H. THOMPSON
Keyword(s):  
Cesarean Section ◽  
Spinal Hypotension

A prospective randomized study to assess the efficacy of post-operative nasal medication after endonasal surgery

1995 ◽  
Vol 109 (7) ◽  
pp. 618-621 ◽  
Author(s):  
Paul D. R. Spraggs ◽  
Marcelle Macnamara ◽  
Theo Joseph
Keyword(s):  
Randomized Study ◽  
Correlation Coefficients ◽  
Control Group ◽  
Time Intervals ◽  
Treatment Groups ◽  
Ephedrine Hydrochloride ◽  
Patent Airway ◽  
Significant Difference ◽  
Blood Clots ◽  
Betamethasone Sodium Phosphate

AbstractPost-operative nasal medications are commonly used following routine septal or turbinate surgery but their efficacy in removing blood clots, improving the sensation of a patent airway and promoting healing are unknown. This prospective randomized trial of patients undergoing septal and/or turbinate surgery assessed the efficacy of three commonly used nasal medicines, 0.5 per cent ephedrine hydrochloride nasal drops, betamethasone sodium phosphate (Betnosol®) nose drops and alkaline nasal douches, in producing the sensation of a patent airway in the 14 days following surgery. Ninety-seven patients were randomized into the three treatment groups and a control group who received no nasal medication. Patients assessed their nasal patency by means of a visual analogue scale (VAS) and any complications of treatment were recorded. Statistical analysis of the 76 complete sets of results using the Mann-Whitney U-test showed that there was a significant difference in the distribution of all of the treatments for each of the time intervals (p<0.05). Glass rank biserial correlation coefficients were all small (rg<0.085) but the most significant differences were between ephedrine and the control group at two hours, two, seven and 10 days (0.02, 0.054, 0.057, 0.085 respectively), alkaline nasal douches being most significant at four and 14 days (0.06 and 0.0722 respectively).

Norepinephrine as an Alternative in Hypotension Prophylaxis During Cesarean Sectionunder Spinal Anesthesia

QJM ◽  
2021 ◽  
Vol 114 (Supplement_1) ◽  
Author(s):  
Mohamed I Shahin ◽  
Ayman M Kamaly ◽  
Mohamed Saleh ◽  
Ashraf E El-Agamy
Keyword(s):  
Blood Pressure ◽  
Spinal Anesthesia ◽  
Cesarean Delivery ◽  
Hypotensive Effect ◽  
Maternal Blood ◽  
Cesarean Sections ◽  
Fluid Loading ◽  
Elective Cesarean ◽  
Spinal Hypotension ◽  
Maternal Blood Pressure

Abstract Background Spinal anesthesia is the preferred method for elective cesarean sections (C.S.) due to considerable risks regarding airway management associated with physiological changes of pregnancy. Hypotension is reported to occur in up to 80% of spinal anesthesia cases. Many approaches have been investigated to prevent spinal hypotension, e.g., fluid loading, vasopressors, or both. Thus we compare the administration of intermittent I.V. boluses of norepinephrine and ephedrine to guard against the hypotensive effect of spinal anesthesia during cesarean delivery. Patients and Methods 120 female patients undergoing electiveC.S.were randomly divided into “group-E” for Ephedrine and “group-N” for Norepinephrine. Results Compared with ephedrine, norepinephrine maintained maternal blood pressure and uterine artery blood flow. Further, it was associated with lower numbers of hypotension and hypertension episodes and less frequency of bradycardia and tachycardia during cesarean delivery. Conclusion Norepinephrine can be used as an alternative vasopressor to maintain maternal blood pressure during spinal anesthesia for cesarean delivery, with no adverse effect on neonatal outcome.

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