Key result
Preeclamptic parturients experienced a significantly smaller percentage decrease in mean arterial pressure following spinal anesthesia compared to healthy controls (22.23% vs 28.06%, p=0.045).
Why the study?
Does spinal anesthesia cause less severe hypotension in preeclamptic parturients compared to healthy parturients undergoing caesarean delivery?
Cohort (n=100)
No
Does spinal anesthesia cause less severe hypotension in preeclamptic parturients compared to healthy parturients undergoing caesarean delivery?
Absolute Event Rate: -22.23% vs -28.06%
p-value: p=0.045
Spinal anesthesia is a safe alternative to epidural anesthesia in preeclamptic parturients, as it induces less severe hypotension and requires less vasopressor support compared to healthy parturients.
Spinal anesthesia may induce less hypotension in preeclamptics; leaves open whether this alters vasopressor needs or caesarean outcomes.
In this prospective cohort study, we compared the incidence and severity of spinal anesthesia (SA) associated hypotension in pre eclamptics (n=50) versus healthy parturients (n=50) undergoing caesarean delivery before due date to avoid the effects of pre eclampsia on mother and baby. After proper preloading, SA was administered with 0.5% hyperbaric bupivacaine. Blood pressure (BP) was recorded before performing SA(baseline BP), and then after SA, every 2 minutes for 30 minutes, and thereafter, every 5 minutes up to completion of surgery. The pre eclamptic patients had a less frequent incidence of clinically significant hypotension, which was less severe and required less ephedrine. The risk of hypotension was significantly less in pre eclamptic patients than that in healthy patients. Spinal anesthesia seemed to be a useful and safe option, and alternative to epidural anesthesia, in pre eclamptic patients in setting of large patient turn up for caesarean deliveries.
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Deshpande et al. (2014) conducted a cohort in Preeclampsia (n=100). Preeclampsia vs. Healthy parturients was evaluated on Decrease in mean arterial pressure (MAP) from baseline at the lowest value (%) (p=0.045). Preeclamptic parturients experienced a significantly smaller percentage decrease in mean arterial pressure following spinal anesthesia compared to healthy controls (22.23% vs 28.06%, p=0.045).
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