Why the study?
What is the current practice among UK consultant obstetric anaesthetists for preventing and managing hypotension during spinal anaesthesia for elective Caesarean section?
What is the current practice among UK consultant obstetric anaesthetists for preventing and managing hypotension during spinal anaesthesia for elective Caesarean section?
Despite literature disputing its value, the majority of UK consultant obstetric anaesthetists continue to routinely use fluid preloading and ephedrine for managing hypotension during spinal anaesthesia for Caesarean section.
Reveals disconnect between disputed evidence and UK obstetric anaesthesia practice; leaves open barriers to evidence-based adoption.
Hypotension during obstetric spinal anaesthesia has traditionally been managed by such measures as fluid preloading, positioning of the patient and the use of vasoconstrictors. However, studies and reports have regularly appeared in the literature disputing the value of conventional management, in particular, the fluid preload. With this in mind, we surveyed UK consultant obstetric anaesthetists to determine current practice in this area. Of the 558 respondents, 486 (87.1%) stated that they routinely give a fluid preload. The fluid chosen by 405 (83.3%) of the preloaders was Hartmann's solution and the usual volume, chosen by 194 (39.9%), was 1000 ml. A simple left lateral position was preferred by 221 respondents (39.6%) overall and in the treatment of hypotension, ephedrine was the sole vasoconstrictor selected by 531 (95.2%). Heavy bupivacaine 0.5% was the local anaesthetic chosen by 545 (97.7%) and 407 (72.9%) respondents indicated the use of additional spinal drugs.
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Burns et al. (2001) studied this question.
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