Open AccessRandomised controlled trial of combined spinal epidural vs. spinal anaesthesia for elective caesarean section: vasopressor requirements and cardiovascular changes
Author(s) -
Alan Macfarlane,
A. Pryn,
K. Litchfield,
F. Bryden,
Steven J. Young,
Christopher J. Weir,
Elizabeth McGrady
Publication year - 2009
Publication title -
european journal of anaesthesiology
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.445
H-Index - 76
eISSN - 1365-2346
pISSN - 0265-0215
DOI - 10.1097/eja.0b013e328319c153
Subject(s) - medicine , anesthesia , ephedrine , hemodynamics , blood pressure , caesarean section , impedance cardiography , vascular resistance , bupivacaine , cardiac index , mean arterial pressure , cardiac output , heart rate , pregnancy , stroke volume , biology , genetics
Combined spinal and epidural anaesthesia (CSEA) has previously been shown to result in a higher sensory block than equivalent single shot spinal anaesthesia (SSSA). In nonpregnant patients, hypotension was also more pronounced in the CSEA group. The aim of this randomized trial was to compare the haemodynamic stabilities of CSEA and SSSA during elective caesarean section when the same dose of anaesthetic was administered. This was studied directly by measuring the noninvasive arterial blood pressure (BP) and indirectly by the amount of ephedrine required to maintain baseline BP. Systemic vascular resistance index (SVRI) and cardiac index (CI) were also measured using thoracic impedance cardiography.