| A survey of the management of spinal-induced hypotension for scheduled cesarean delivery. | |
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MedLine Citation:
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PMID: 19734039 Owner: NLM Status: MEDLINE |
Abstract/OtherAbstract:
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BACKGROUND: Intravenous fluids and vasopressors are used for managing spinal-induced hypotension during cesarean delivery, but the choice of vasopressor and the type and timing of fluid administration remain controversial. METHODS: We conducted an electronic survey of all members of the Society for Obstetric Anesthesia and Perinatology between February and March 2007 to determine their preferences for preventing and treating spinal-induced hypotension with respect to fluid and vasopressor administration. RESULTS: The response rate was 292/746 (39%). Fifty percent worked in academic institutions and 56% had >50% of their clinical responsibility to obstetric anesthesia. For prophylaxis, 35% used fluid preloading, 30% fluid preloading with vasopressors, and 12% fluid co-loading with vasopressors. Of those using vasopressors for prophylaxis, 32% used ephedrine, 26% used phenylephrine, and 33% based their choice on heart rate. For treatment, 32% used ephedrine, 23% used phenylephrine, and 41% used either agent based on heart rate. Anesthesiologists in academic practice were less likely to use fluid preloading only (P=0.028) and more likely to use fluid co-loading and vasopressors (P=0.003). They were also more likely to administer phenylephrine for prophylaxis compared with those in private practice (P=0.042). CONCLUSION: Significant variations in practice exist in the prevention and treatment of spinal-induced hypotension. Fluid preloading and the prophylaxis and treatment of hypotension with ephedrine continue to be common practices. |
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Authors:
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T K Allen; H A Muir; R B George; A S Habib |
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Publication Detail:
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Type: Journal Article Date: 2009-09-05 |
Journal Detail:
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Title: International journal of obstetric anesthesia Volume: 18 ISSN: 1532-3374 ISO Abbreviation: Int J Obstet Anesth Publication Date: 2009 Oct |
Date Detail:
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Created Date: 2009-09-28 Completed Date: 2009-12-07 Revised Date: - |
Medline Journal Info:
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Nlm Unique ID: 9200430 Medline TA: Int J Obstet Anesth Country: Netherlands |
Other Details:
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Languages: eng Pagination: 356-61 Citation Subset: IM |
Affiliation:
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Department of Anesthesiology, Duke University Medical Center, Durham, North Carolina 27710, USA. |
Export Citation:
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| MeSH Terms | |
Descriptor/Qualifier:
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Adult Anesthesia, Obstetrical / adverse effects* Anesthesia, Spinal / adverse effects* Cesarean Section* Delivery, Obstetric Drug Utilization Ephedrine / therapeutic use Female Fluid Therapy Great Britain Health Care Surveys Humans Hypotension / etiology*, prevention & control, therapy* Phenylephrine / therapeutic use Pregnancy Questionnaires Vasoconstrictor Agents / therapeutic use |
| Chemical | |
Reg. No./Substance:
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0/Vasoconstrictor Agents; 299-42-3/Ephedrine; 59-42-7/Phenylephrine |
From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine
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