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Maternal Haemodynamic Changes during Caesarean Section: A Comparison of Epidural and General Anaesthesia
Author(s) -
MILSOM I.,
FORSSMAN L.,
BIBER B.,
DOTTORI O.,
RYDGREN B.,
SIVERTSSON R.
Publication year - 1985
Publication title -
acta anaesthesiologica scandinavica
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.738
H-Index - 107
eISSN - 1399-6576
pISSN - 0001-5172
DOI - 10.1111/j.1399-6576.1985.tb02178.x
Subject(s) - medicine , anesthesia , impedance cardiography , hemodynamics , stroke volume , cardiac output , heart rate , blood pressure , mean arterial pressure , caesarean section , vascular resistance , pregnancy , biology , genetics
Haemodynamic measurements were performed on 20 healthy women before and during elective caesarean section under epidural (10 women) or general anaesthesia (10 women). The influence of the two anaesthetic techniques on the haemodynamic changes associated with operative delivery was compared. The following haemodynamic variables were studied: cardiac output (CO), stroke volume (SV) determined non‐invasively with impedance cardiography, heart rate (HR), systolic (SBP) and diastolic blood pressure (DBP), pulse pressure, mean arterial pressure (MAP) and total peripheral vascular resistance (TPR). During epidural anaesthesia, SV was largely unchanged before delivery but increased ( P <0.05) following delivery. However, CO increased ( P <0.05) prior to delivery due to an increase ( P <0.01) in HR. A further increase ( P <0.05) in CO was recorded following delivery. SBP, DBP, MAP and TPR decreased ( P <0.01) during epidural anaesthesia. In the patients undergoing general anaesthesia, SV decreased ( P <0.05) prior to delivery. However, CO remained largely unchanged due to an increase ( P <0.01) in HR. Following delivery, CO ( P <0.05) and SV ( P <0.01) increased whereas HR decreased ( P <0.01). SBP, DBP and MAP increased ( P <0.01) prior to delivery, returning to the same level as prior to induction of anaesthesia following delivery. TPR was largely unchanged prior to delivery but decreased ( P <0.01) following delivery.