Anesthesia for cesarean section pdf

Cricoid pressure can only be accurately performed by trained caregivers and should be released if intubation appears to be difficult. Supra-glottic airway devices may safely be used in fasted, nonobese elective caesarean section, but endotracheal intubation remains the gold standard, especially in emergency caesarean section in labouring women.

Both sevoflurane and propofol are appropriate for the maintenance of general anaesthesia during caesarean section. Therefore, this study Preoperative fasting duration was asked from the patient in the was conducted on pregnant women undergoing cesarean section operation theatre. We also recorded variables related to spinal under spinal anesthesia to find the rate of predelivery hypotension anaesthesia such as the amount and type of preloading and co- based on the inclusion and exclusion criteria.

The most preoperative scores by the anesthesia provider. Thus, the same definition was used in this study. The high ASA classification has the highest operative all the attending anesthetists treat when systolic blood pressure is risk. Data were entered and validated in Epi Data 3. Descriptive data are expressed in terms of percentages, ratios, mean and median. The Chi-square test JDWNRH for caesarean delivery under spinal anaesthesia from was used for categorical and unpaired t-test for the continuous 01st October to 30th June The study was approved by data.

Women coming to cesarean section were selected through systematic random sampling. The first patient was selected through lucky dip from the operating list. Details about patient selection is shown in Figure 1. No procedure or management modification was done for this study.

Due to the limited number of anesthesiologists in the country, certified nurse anesthesia placed spinal anesthesia Figure 1. Flow chart showing selection of women undergoing without supervision. Anesthesiologists are called if needed.

Hypotension with the youngest being 18 years old and the eldest being 43 years was developed by women Similarly, the singleton pregnancy and 32 9. Factors associated with hypotension after spinal hours. The mean preoperative fasting duration in elective and anesthesia among women undergoing cesarean section at emergency was 13 hours and 7. Table 1 shows Hypertension in 0.

Table 2 shows the detailed description of anesthetic techniques. Hypertension during risk factors and three protective factors. The risk factors that pregnancy was a protective factor for the development of increase hypotension after spinal anesthesia in cesarean sections hypotension AOR 0. The protective AOR 0.

To our The pre-delivery hypotension rate in this study was The higher rate of predelivery hypotension in this study undergoing cesarean section under spinal anesthesia. Longer could be due to the differences in definition. High baseline sympathetic mm Hg.

A similar outcome was observed by Klohr et al with even activity was associated with spinal hypotension In our setting, minor differences in definition leading to significant differences we have one operation room fully dedicated to the cesarean in the incidence of hypotension The predelivery hypotension section for both elective and emergency cesareans.

Women per se is not studied much and is limited in the literature. With the scheduled for elective cesarean sections have fasted longer than use of oxytocin and blood loss from the uterus incision, the rate of 13 hours. This was because emergency cesareans were performed hypotension cannot be compared with predelivery hypotension. The surgeon and The vasodilatory effect of oxytocin and blood loss will decrease anesthetist should plan accordingly to reduce the fasting hours in blood pressure further.

The degree of blood pressure drop will the elective cesareans. The results of the present study agree ephedrine was used by Among many factors, variability of Without pharmacological prophylaxis, the rate of lumbosacral cerebrospinal fluid could be the most important hypotension in our study was comparable to the report by Mercier factor which affects the spread of local anesthesia Similarly, the use of non-pharmacological methods like leg height5,6,10 obesity7 and intra-abdominal pressure10 influences wrapping, table tilt and wedge under the hip was less in our study.

Another factor that These methods alleviate compression of inferior vena cava by influences the spread of anesthesia is the position and baricity gravid uterus and pooling of blood in lower limbs. Hassanain et of local anesthesia Measures to avoid high spinal block are al observed the changing the position from supine to left lateral low dose local anesthesia31, adjusting the dose of bupivacaine position increased cardiac output and heart rate Kundra et al according to the patients height5,6 and BMI8,31, slow injection also observed that the maternal blood flow velocities and wave of local anesthesia28, administering local anesthesia in sitting increases when full-term women were placed in left lateral tilt position32 and isobaric local anesthesia Similarly, leg elevation22 and compression 23 in clinical The odds of developing hypotension when baseline trials showed a reduced incidence of hypotension.

Enter the email address you signed up with and we'll email you a reset link. Need an account? Click here to sign up. Download Free PDF. Ingemar Kjellmer. A short summary of this paper. Anesthesia for Cesarean Section IV. Acta anaesth. A gas-chromatographic micro-method was used for the analysis. The aim of this investigation was to evaluate the placental transfer and the elimination rate of the drug. No signs of systemic toxicity were observed in any mother or child, despite relatively high blood concentrations.

The fetal-maternal ratio of concentrations a t delivery was higher than in previous studies, most probably due to the protein- binding characteristics of bupivacaine and the dosage used. The half-life of the slow phase of elimination b-phase in the newborn was of the same magni- tude as in the mother, indicating that neonatal elimination processes of bupivacaine may be well developed a t birth. Received 2 1 August, accepted f o r publication 25 September 1 9 7 5 Since four cases of accidental fetal intoxica- side, the circulation, tissue solubility, absorp- tion with local anesthetic drug during caudal tion and excretion, as well as drug meta- anesthesia were reported FINSTERet al.

Placen- Like other local anesthetics of the amide tal transfer of drugs is dependent on a series group, bupivacaine is extensively meta- of factors, such as protein-binding, degree of bolized in the adult before excretion REY- ionization and lipid solubility, molecular NOLDS a. The present study was designed weight, and characteristics of placental to elucidate the degree of placental transfer membrane and blood flow.

All samples were frozen and stored at " C. The neonatal samples from the abdominal aorta were collected through the catheter used for blood gas sampling. Posted with permission. Collections Publications. Full item page. Show statistical information.