Low-dose spinal anaesthesia for Caesarean section to prevent spinal-induced hypotension

Current Opinion in Anaesthesiology

Volumn 21, Issue 3, 2008, Pages 259-262

  Roofthooft, Eva ^a   Van De Velde, Marc ^b  

^a MIDDELHEIM HOSPITAL   (Belgium)

^b UNIVERSITY HOSPITALS LEUVEN   (Belgium)

Author keywords

Caesarean section; Combined spinal epidural anaesthesia; Low dose spinal; Obstetric anaesthesia

Indexed keywords

ANESTHETIC AGENT; BUPIVACAINE; EPHEDRINE; FENTANYL;

CESAREAN SECTION; CLINICAL TRIAL; DOSE RESPONSE; DYSPNEA; EPIDURAL ANESTHESIA; FETUS OUTCOME; HEMODYNAMICS; HUMAN; HYPOTENSION; INSTRUMENTAL DELIVERY; LOW DRUG DOSE; METHODOLOGY; NAUSEA AND VOMITING; OUTCOME ASSESSMENT; PRIORITY JOURNAL; REVIEW; SPINAL ANESTHESIA;

ANESTHESIA, OBSTETRICAL; ANESTHESIA, SPINAL; ANESTHETICS, LOCAL; BUPIVACAINE; CESAREAN SECTION; DOSE-RESPONSE RELATIONSHIP, DRUG; EVIDENCE-BASED MEDICINE; FEMALE; HUMANS; HYPOTENSION; MOTOR ACTIVITY; PREGNANCY; TREATMENT OUTCOME;

EID: 43149085027     PISSN: 09527907     EISSN: None     Source Type: Journal    
DOI: 10.1097/ACO.0b013e3282ff5e41     Document Type: Review

References (33)

1. Jenkins JG, Khan MM. Anaesthesia for Caesarean section: a survey in a UK region from 1992 to 2002. Anaesthesia 2003; 58:1114-1118.
2. Ngan Kee WD, Khaw KS, Lee BB, et al. A dose-response study of prophylactic intravenous ephedrine for the prevention of hypotension during spinal anesthesia for cesarean delivery. Anesth Analg 2000; 90:1390-1395.
3. Rout CC, Rocke DA, Levin J, et al. A reevaluation of the role of crystalloid preload in the prevention of hypotension associated with spinal anesthesia for elective cesarean section. Anesthesiology 1993; 79:262-269.
4. Tercanli S, Schneider M, Visca E, et al. Influence of volume preloading on uteroplacental and fetal circulation during spinal anaesthesia for Caesarean section in uncomplicated singleton pregnancies. Fetal Diagn Ther 2002; 17:142-146.
5. Roberts SW, Leveno KJ, Sidawi JE, et al. Fetal acidemia associated with regional anesthesia for elective Cesarean delivery. Obstet Gynecol 1995; 85:79-83.
6. Reynolds F, Seed PT. Anaesthesia for Caesarean section and neonatal acid-base status: a meta-analysis. Anaesthesia 2005; 60:636-653.
7. Skillman CA, Plessinger MA, Woods JR, Clark KE. Effect of graded reductions in uteroplacental blood flow on the fetal lamb. Am J Physiol 1985; 249:H1098-H1105.
8. Burns SM, Cowan CM, Wilkes RG. Prevention and management of hypotension during spinal anaesthesia for elective Caesarean section: a survey of practice. Anaesthesia 2001; 56:794-798.
9. Tsen LC, Boosalis P, Segal S, et al. Hemodynamic effects of simultaneous administration of intravenous ephedrine and spinal anesthesia for cesarean delivery. J Clin Anesth 2000; 12:378-382.
10. Rocke DA, Rout CC. Volume preloading, spinal hypotension and Caesarean section. Br J Anaesth 1995; 75:257-259.
11. Jackson R, Reid JA, Thorburn J. Volume preloading is not essential to prevent spinal-induced hypotension at Caesarean section. Br J Anaesth1995; 75:262-265.
12. Vercauteren MP, Hoffmann V, Coppejans HC, et al. Hydroxyethylstarch compared with modified gelatin as volume preload before spinal anaesthesia for Caesarean section. Br J Anaesth 1996; 76:731-733.
13. Mercier FJ, Riley ET, Frederickson WL, et al. Phenylephrine added to prophylactic ephedrine infusion during spinal anesthesia for elective cesarean section. Anesthesiology 2001; 95:668-674.
14. Emmett RS, Cyna AM, Andrew M, Simmons SW. Techniques for preventing hypotension during spinal anaesthesia for Caesarean section. Cochrane Library 2003; (3).
15. Lee A, Ngan Kee WD, Gin T. Prophylactic ephedrine prevents hypotension during spinal anesthesia for cesarean delivery but does not improve neonatal outcome: a quantitative systematic review. Can J Anaesth 2002; 49:588-599.
16. Cyna AM, Andrew M, Emmett RS et al. Techniques for preventing hypotension during spinal anaesthesia for caesarean section [review]. The Cochrane Library 2007; (4). Excellent meta-analysis reviewing the scientific evidence on the various methods that have been described to prevent maternal hypotension during spinal anaesthesia for Caesarean section.
17. Lee A, Ngan Kee WD, Gin T. A dose-response meta-analysis of prophylactic intravenous ephedrine for the prevention of hypotension during spinal anesthesia for elective cesarean delivery. Anesth Analg 2004; 98:483-490.
18. Lai FM, Jenkins JG. Ventricular bigeminy during phenylephrine infusion used to maintain normotension during caesarean section under spinal anaesthesia [case report]. Int J Obstet Anesth 2007; 16:288-290.
19. Fan SZ, Susetio L, Wang YP, et al. Low dose of intrathecal hyperbaric bupivacaine combined with epidural lidocaine for Cesarean section: a balance block technique. Anesth Analg 1994; 78:474-477.
20. Ben-David B, Miller G, Gavriel R, Gurevitch A. Low-dose bupivacaine-fentanyl spinal anesthesia for cesarean delivery. Reg Anesth Pain Med 2000; 25:235-239.
21. Vercauteren MP, Coppejans HC, Hoffmann VL, et al. Small-dose hyperbaric versus plain bupivacaine during spinal anesthesia for cesarean section. Anesth Analg 1998; 86:989-993.
22. Vercauteren MP, Coppejans HC, Hoffman VH, et al. Prevention of hypotension by a single 5-mg dose of ephedrine during small dose spinal anesthesia in prehydrated Cesarean delivery patients. Anesth Analg 2000; 90:324-327.
23. Coppejans HC, Hendrickx E, Goossens J, Vercauteren MP. The sitting versus right lateral position during combined spinal-epidural anesthesia for Cesarean delivery: block characteristics and severity of hypotension. Anesth Analg 2006; 102:243-247.
24. Coppejans HC, Vercauteren MP. Low-dose combined spinal-epidural anesthesia for Cesarean delivery: a comparison of three plain local anesthetics. Acta Anaesthesiol Belg 2006; 57:39-43.
25. Choi DH, Ahn HJ, Kim JA. Combined low-dose spinal-epidural anesthesia versus single shot spinal anesthesia for elective cesarean delivery. Int J Obstet Anesth 2006; 15:13-17.
26. Van de Velde M, Van Schoubroeck D, Jani J, et al. Combined spinal epidural anesthesia for Cesarean section: dose dependent effects of hyperbaric bupivacaine on maternal hemodynamics. Anesth Analg 2006; 103:187-190.
27. Chen X-Z, Chen H, Lou A-F, Lü C-C. Dose-response study of spinal hyperbaric ropivacaine for caesarean section. J Zhejiang Univ Sci B 2006; 7:992-997.
28. Teoh WHL, Thomas E, Tan HM. Ultra-low dose combined spinal-epidural anesthesia with intrathecal bupivacaine 3.75 mg for cesarian delivery: a randomized controlled trial. Int J Obstet Anesth 2006; 15:273-278.
29. Teoh WHL, Sia ATH. Ultra-low dose combined spinal-epidural anaesthesia for Caesarean section in severe preeclampsia. Anaesthesia 2006; 61:511-512.
30. Kaya S, Karaman H, Erdogan H, et al. Combined use of low-dose bupivacaine, colloid preload and wrapping of the legs for preventing hypotension in spinal anaesthesia for caesarian section. J Int Med Res 2007; 35:615-625. Elegant study which clearly demonstrates the efficacy of low-dose spinal techniques. The study also shows the superior haemodynamics of low-dose spinals combined with leg wrapping and fluid loading.
31. Ghazi A, Raja Y. Combined low-dose spinal-epidural anaesthesia versus single-shot spinal anaesthesia for elective caesarean delivery. Int J Obstet Anesth 2007; 16:90-91.
32. McNaught AF, Stocks GM. Epidural volume extension and low-dose sequential combined spinal-epidural blockade: two ways to reduce spinal dose requirement for caesarean section [review]. Int J Obstet Anesth 2007; 16:346-353.
33. Evans L, Adekanye O. Ultra-low dose combined spinal-epidural anaesthesia. Int J Obstet Anesth 2007; 16:387-388.