Head Elevation in Spinal-Epidural Anesthesia Provides Improved Hemodynamics and Appropriate Sensory Block Height at Caesarean Section
Yonsei Medical Journal
;
: 1122-1127, 2015.
Article
Dans Anglais
| WPRIM
| ID: wpr-150470
ABSTRACT
PURPOSE:
We aimed to determine whether head elevation during combined spinal-epidural anesthesia (CSE) and Caesarean section provided improved hemodynamics and appropriate sensory block height. MATERIALS ANDMETHODS:
Forty-four parous women undergoing CSE for elective Caesarean section were randomly assigned to one of two groups right lateral (group L) or right lateral and head elevated (group HE) position, for insertion of the block. Patients were positioned in the supine wedged position (group L) or the left lateral and head elevated position (group HE) until a block height of T5 to light touch was reached. Group HE was then turned to the supine wedged position with maintenance of head elevation until the end of surgery. Hemodynamics, including the incidence of hypotension, ephedrine dose required, and characteristics of the sensory blocks were analyzed.RESULTS:
The incidence of hypotension (16 versus 7, p=0.0035) and the required dose of ephedrine [24 (0-40) versus 0 (0-20), p<0.0001] were greater in group L compared to group HE. In group L, the time to achieve maximal sensory block level (MSBL) was shorter (11.8+/-5.4 min versus 20.1+/-6.3 min, p<0.0001) and MSBL was also higher than in group HE [14 (T2) versus 12 (T4), p=0.0015].CONCLUSION:
Head elevation during CSE and Caesarean section is superior to positioning without head elevation in the lateral to supine position, as it is associated with a more gradual onset, appropriate block height, and improved hemodynamics.
Texte intégral:
Disponible
Indice:
WPRIM (Pacifique occidental)
Sujet Principal:
Pression sanguine
/
Césarienne
/
Résultat thérapeutique
/
Interventions chirurgicales non urgentes
/
Positionnement du patient
/
Tête
/
Hémodynamique
/
Hypotension artérielle
/
Anesthésie péridurale
/
Anesthésie obstétricale
Limites du sujet:
Adulte
/
Femelle
/
Humains
/
Grossesse
langue:
Anglais
Texte intégral:
Yonsei Medical Journal
Année:
2015
Type:
Article
Documents relatifs à ce sujet
MEDLINE
...
LILACS
LIS