Management of hypotension after spinal anesthesia during caesarean section: a multicenter survey of physicians and review of the literature
| Autor: | N.V. Tytarenko, A.V. Vozniuk, O.I. Datsiuk, E.V. Slyvka, S.K. Litvinov, A.V. Kostiuchenko, G.M. Mazur, O.V. Sergiychuk, G.V. Bevz |
|---|---|
| Jazyk: | English<br />Ukrainian |
| Rok vydání: | 2023 |
| Předmět: | |
| Zdroj: | Медицина неотложных состояний, Vol 19, Iss 5, Pp 345-351 (2023) |
| Druh dokumentu: | article |
| ISSN: | 2224-0586 2307-1230 |
| DOI: | 10.22141/2224-0586.19.5.2023.1610 |
| Popis: | Background. Hypotension during caesarean section under spinal anesthesia occurs in 75–90 % of cases and may causes adverse effects in a mother and newborn. The purpose of the work is to analyze the adherence of anesthesiologists to the guidelines of current protocols on the management of hypotension during spinal anesthesia in maternity hospitals/departments of Vinnytsia and Vinnytsia region. Materials and methods. We conducted a multicenter survey involving 70 anesthesiologists from 21 maternity hospitals or departments of medical facilities in Vinnytsia and Vinnytsia region. Our electronic questionnaire included questions about measures to prevent and treat hypotension during cesarean section under spinal anesthesia. Results. 98.5 % of 70 anesthesiologists who provide care for the obstetric patients in Vinnytsia and Vinnytsia region routinely use phenylephrine to maintain hemodynamics after spinal anesthesia. However, the share of respondents who use a vasopressor prophylactically is only 15.7 %. It was found that, in addition to phenylephrine, doctors perform non-pharmacological prevention of hypotension after spinal anesthesia: 35.7 % — prevention of aortocaval compression, 8.5 and 12.9 % — elastic compression of the lower extremities with/without prevention of aortocaval compression, respectively. Also, most anesthesiologists (67.1 %) prescribe pre-infusion with both crystalloids and colloids and the subsequent post-infusion volume of crystalloid solutions is 400 to 1500 ml or more. According to the data obtained, anesthesiologists in Vinnytsia region most often use hyperbaric bupivacaine (60 %); isobaric bupivacaine (35.7 %) and lidocaine (4.3 %) for spinal anesthesia are used less often. Conclusions. The analysis of current practice indicates the need to develop and implement a clear unified strategy for managing hypotension with vasopressors during caesarean section under spinal anesthesia within the framework of the program of accelerated recovery of women in labor in Vinnytsia and Vinnytsia region. |
| Databáze: | Directory of Open Access Journals |
| Externí odkaz: |
|