Key result
Spinal anesthesia during cesarean section is associated with ~32% arrhythmia incidence without adverse neonatal outcomes.
Why the study?
The possible causative factors of arrhythmia during cesarean section under spinal anesthesia and its effects on immediate post-delivery neonatal outcomes are not well established.
What are the incidence, risk factors, and neonatal impacts of arrhythmia during cesarean section under spinal anesthesia?
Observational (n=216)
No
What are the incidence, risk factors, and neonatal impacts of arrhythmia during cesarean section under spinal anesthesia?
Arrhythmias during cesarean section under spinal anesthesia are associated with higher bupivacaine doses and uterine manipulation, but do not adversely affect immediate neonatal outcomes.
Answers are grounded in this paper and cite their sources.
Arrhythmias during cesarean section under spinal anesthesia may not affect neonatal outcomes; observational data leaves open questions on prevention and long-term effects.
INTRODUCTION: Various types of arrhythmia have been reported during cesarean section under spinal anesthesia. But the possible causative factors and the effects of arrhythmia on immediate post-delivery neonatal outcome are not well established. METHODS: This prospective observational study was conducted over a period of one year in a tertiary care hospital on women undergoing cesarean section under spinal anesthesia. The objectives of the study were to determine the incidence of arrhythmia, its types, the possible factors influencing arrhythmia, and the immediate post-delivery neonatal outcome. Data collected were analyzed using Statistical Package for the Social Sciences (SPSS) software version 21 (IBM Corp. Armonk, NY). RESULTS: level and dose of intrathecal hyperbaric bupivacaine was more than 2.2 mL (P value <0.05). Also, uterine manipulation led to sudden bradycardia and transient cardiac asystole in two patients which was preceded by subjective symptoms of pain and discomfort. None of the neonates required cardiopulmonary resuscitation or neonatal intensive care unit admission within an hour of birth. APGAR (Appearance (skin color), Pulse (heart rate), Grimace (reflex irritability), Activity (muscle tone), and Respiration) scores at 1 and 5 minutes were similar in all the newborns born to mothers with or without arrhythmia. CONCLUSION: using lower possible drug dose to provide adequate level of sensory block, prompt management of hypotension, and strict monitoring during uterine manipulation may reduce the overall incidence of arrhythmia. Intraoperative arrhythmia, however, does not adversely affect the immediate post-delivery neonatal outcome.
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Dev et al. (2021) conducted an observational in Pregnancy requiring cesarean section (n=216). Spinal anesthesia was evaluated on Incidence of arrhythmia. During cesarean section under spinal anesthesia, the incidence of arrhythmia was 31.9%, with sinus bradycardia being the most common type, and it did not adversely affect immediate neonatal outcomes.
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