Document Detail


Spinal versus epidural anesthesia for cesarean delivery in severe preeclampsia: a prospective randomized, multicenter study.
MedLine Citation:
PMID:  16116005     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
In this randomized, multicenter study we compared the hemodynamic effects of spinal and epidural anesthesia for cesarean delivery in severely preeclamptic patients. The epidural group (n = 47) received 2% lidocaine with epinephrine 1:400,000, 18-23 mL, followed by 3 mg of morphine after delivery. The spinal group (n = 53) received 2.2 mL of 0.5% hyperbaric bupivacaine plus 0.2 mg morphine. We hypothesized that the lowest MAP (mean arterial blood pressure, the primary outcome) during the delivery period would have to be at least 10 mm Hg less in the spinal group to be of clinical importance. We found that there was a statistically significant difference in MAP, with more patients in the spinal group exhibiting hypotension (P < 0.001). Although the incidence of hypotension (systolic arterial blood pressure, SAP < or =100 mm Hg) was more frequent in the spinal group than in the epidural group (51% versus 23%), the duration of significant hypotension (SAP < or =100 mm Hg) was short (< or =1 min) in both groups. There was more use of ephedrine in the spinal group than in the epidural group (median, 6 versus 0 mg) but hypotension was easily treated in all patients. Neonatal outcomes assessed by Apgar scores and the umbilical arterial blood gas analysis were similar in both groups. Adverse neonatal outcomes (5-min Apgar score < 7 and umbilical arterial blood pH < 7.20) were found in only 2 premature newborns (weight < 1500 g) who were born without maternal hypotension after regional anesthesia. We conclude that the results of this large prospective study support the use of spinal anesthesia for cesarean delivery in severely preeclamptic patients.
Authors:
Shusee Visalyaputra; Oraluxna Rodanant; Wanna Somboonviboon; Kamthorn Tantivitayatan; Somboon Thienthong; Wanawimol Saengchote
Related Documents :
11878725 - Improvement of 'dynamic analgesia' does not decrease atelectasis after thoracotomy.
12691335 - Optimal stimulation duration of tens in the management of osteoarthritic knee pain.
10099055 - Retrospective case-control evaluation of the use of parenteral ketorolac tromethamine i...
12651665 - Intrathecal clonidine added to a bupivacaine-morphine spinal anesthetic improves postop...
19745175 - Effects of moderate-dose omega-3 fish oil on cardiovascular risk factors and mood after...
17873815 - The relationship between thoracic hyperkyphosis and the scoliosis research society outc...
Publication Detail:
Type:  Clinical Trial; Comparative Study; Journal Article; Multicenter Study; Randomized Controlled Trial; Research Support, Non-U.S. Gov't    
Journal Detail:
Title:  Anesthesia and analgesia     Volume:  101     ISSN:  0003-2999     ISO Abbreviation:  Anesth. Analg.     Publication Date:  2005 Sep 
Date Detail:
Created Date:  2005-08-23     Completed Date:  2005-09-27     Revised Date:  2007-11-15    
Medline Journal Info:
Nlm Unique ID:  1310650     Medline TA:  Anesth Analg     Country:  United States    
Other Details:
Languages:  eng     Pagination:  862-8, table of contents     Citation Subset:  AIM; IM    
Affiliation:
Department of Anesthesiology, Siriraj Hospital, Bangkoknoi, Bangkok 10700, Thailand. sisps@mahidol.ac.th
Export Citation:
APA/MLA Format     Download EndNote     Download BibTex
MeSH Terms
Descriptor/Qualifier:
Adult
Anesthesia, Epidural*
Anesthesia, Obstetrical*
Anesthesia, Spinal*
Apgar Score
Birth Weight / physiology
Blood Gas Analysis
Blood Pressure / physiology
Cesarean Section*
Double-Blind Method
Female
Hemodynamics / drug effects,  physiology
Humans
Infant, Newborn
Pre-Eclampsia / physiopathology*
Pregnancy
Comments/Corrections
Comment In:
Anesth Analg. 2006 Dec;103(6):1584; author reply 1584-5   [PMID:  17122251 ]
Anesth Analg. 2005 Sep;101(3):859-61   [PMID:  16116004 ]

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine


Previous Document:  Reducing cerebral blood flow increases the duration of electroencephalographic silence by intracarot...
Next Document:  Spinal anesthesia-induced hypotension: a risk comparison between patients with severe preeclampsia a...