Spinal-induced hypotension at caesarean section

Publication date: Available online 24 May 2016 Source:Anaesthesia & Intensive Care Medicine Author(s): Owen O'Sullivan, Rowena Cockerham While spinal anaesthesia is preferred for caesarean section, spinal-induced hypotension remains a significant problem and may adversely affect mother and baby. Identifying both mothers at particular risk of hypotension and babies at risk of its detrimental effect on uteroplacental circulation may allow a more targeted management. The mainstay of current management includes vasopressors, intravenous fluids and avoidance of aorto-caval compression. Low-dose spinal anaesthesia can also reduce the incidence but risks inadequate anaesthesia. Novel means of predicting or more rapidly detecting spinal-induced hypotension include the use of continuous non-invasive blood pressure monitoring devices and cerebral oximetry. More timely treatment of hypotension can be achieved with the use of computer-aided automated delivery of vasopressors. Future study of this problem would be aided by a common consensus on the definition of hypotension in this context.
Source: Anaesthesia and intensive care medicine - Category: Anesthesiology Source Type: research