Hemodynamic characteristics in preeclampsia women during cesarean delivery after spinal anesthesia with ropivacaine.

Hemodynamic characteristics in preeclampsia women during cesarean delivery after spinal anesthesia with ropivacaine.:

Related Articles

Hemodynamic characteristics in preeclampsia women during cesarean delivery after spinal anesthesia with ropivacaine.

World J Clin Cases. 2020 Apr 26;8(8):1444-1453

Authors: Zhao N, Xu J, Li XG, Walline JH, Li YC, Wang L, Zhao GS, Xu MJ

Abstract

BACKGROUND: Very few studies have been published on the hemodynamic changes associated with spinal anesthesia induced with ropivacaine during cesarean deliveries in preeclamptic women.

AIM: To record and analyze hemodynamic data in women with preeclampsia undergoing cesarean delivery after spinal anesthesia induced with ropivacaine.

METHODS: Ten eligible women with preeclampsia were enrolled in this prospective observational study. Spinal anesthesia was performed with 2.4 mL of 0.5% ropivacaine. Hemodynamic changes were then analyzed at multiple time points. The hemodynamic responses to vasopressor interventions and uterotonic agents, as well as maternal and neonatal outcomes were also recorded.

RESULTS: Stable hemodynamic trends were observed in this study. Cardiac output (CO) and stroke volume increased mildly during surgery. In contrast, mean arterial pressure and systemic vascular resistance showed a moderate decrease from induction until the end of surgery. Central venous pressure dramatically increased after delivery. Oxytocin administration was associated with the most significant hemodynamic fluctuations during surgery, namely, an increase in CO and heart rate. Phenylephrine intervention was only required in three patients, and caused an increase in mean arterial pressure and systemic vascular resistance along with a decrease in heart rate, stroke volume, and CO. No maternal and neonatal complications were observed during this study, except transient episodes of hypotension.

CONCLUSION: Spinal anesthesia for caesarian delivery with ropivacaine in women with preeclampsia is linked to modest hemodynamic changes of no clinical significance in this study. Careful cardiovascular monitoring is still recommended, particularly after the delivery of the fetus or the use of oxytocin.

PMID: 32368536 [PubMed]