A survey in the West Midlands of the United Kingdom of current practice in managing hypotension in lower segment caesarean section under spinal anaesthesia.
Jarvis, M S Blackburn, J Hailstone, C Small, C L Dixon, C Rook, W Maniar, R Graham, J Sengar, T Dunn, S J
Jarvis, M S
Blackburn, J
Hailstone, C
Small, C L
Dixon, C
Rook, W
Maniar, R
Graham, J
Sengar, T
Dunn, S J
Abstract
Spinal anaesthesia, the most common form of anaesthesia for caesarean section, leads to sympathetic blockade and profound maternal hypotension resulting in adverse maternal and neonatal outcomes. Hypotension, nausea and vomiting remain common but until the publication of the National Institute of Health and Care Excellence (NICE) 2021 guidance, no national guideline existed on how best to manage maternal hypotension following spinal anaesthesia for caesarean section. A 2017 international consensus statement recommended prophylactic vasopressor administration to maintain a systolic blood pressure of >90% of an accurate pre-spinal value, and to avoid a drop to <80% of this value. This survey aimed to assess regional adherence to these recommendations, the presence of local guidelines for management of hypotension during caesarean section under spinal anaesthesia, and the individual clinician's treatment thresholds for maternal hypotension and tachycardia.
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Date
2023-06-01
Type
Article
Subject
Anaesthesia, Obstetrics. Midwifery
Citation
Int J Obstet Anesth . 2023 Aug;55:103899
Journal / Source Title
International Journal of Obstetric Anesthesia
DOI
10.1016/j.ijoa.2023.103899
PMID
37329691
Publisher
Elsevier