Perioperative noninvasive cardiac output monitoring in parturients undergoing cesarean delivery with spinal anesthesia and prophylactic phenylephrine drip: a prospective observational cohort study

  title={Perioperative noninvasive cardiac output monitoring in parturients undergoing cesarean delivery with spinal anesthesia and prophylactic phenylephrine drip: a prospective observational cohort study},
  author={Sharon Orbach-Zinger and Ilya Bizman and S Firman and Shaul Lev and Roi Gat and Eran Ashwal and Mordehay Vaturi and Eitan Razinski and Atara Davis and Anat Shmueli and Leonid A. Eidelman},
  journal={The Journal of Maternal-Fetal \& Neonatal Medicine},
  pages={3153 - 3159}
Abstract Introduction: Spinal anesthesia for cesarean delivery is associated with high incidence of hypotension and is most often prevented by a prophylactic phenylephrine infusion (PPI). In this study, we aimed to identify maternal hemodynamic changes both intraoperatively and postoperatively with the use of the NICaS noninvasive cardiac output monitor in healthy singleton parturients undergoing cesarean delivery (CD) with spinal anesthesia and PPI. Methods: Healthy term women undergoing… 
A prospective observational study of the change in regional cerebral oxygen saturation during cesarean delivery in women receiving phenylephrine prophylaxis for spinal hypotension.
Spinal anesthesia with phenylephrine infusion during cesarean delivery is associated with a significant decrease in ScO2 levels, maximal five minutes later, and further studies are required to establish the clinical significance of this finding.
Continuous cardiovascular hemodynamics monitoring with pressure recording analytical method in patients under spinal anesthesia for elective cesarean section: a pilot study.
PRAM of MostCare system revealed significant changes in key hemodynamic parameters undergoing cesarean section with spinal anesthesia, which enables clinicians gain a much better understanding of hemodynamics of parturients and optimize clinical management strategies.
Comparison of efficacy and safety of preemptive infusion protocols of ephedrine and phenylephrine - prevention of hypotension and effects on hemodynamic parameters during spinal anesthesia for caesarean section
E and P vasopressors are both effective in the prevention of hypotension during SA, and SBP, DBP, CO, SV, SVR, and HR were significantly different between the E and P groups.
Влияние анестезиологического пособия на состояние плода
According to the results of a study of scientific literary sources, neuroaxial pain relief methods have practically no effect on the condition of the fetus, provided that the mother has stable hemodynamics.
Анестезиологическое обеспечение абдоминального родоразрешения женщин с многоплодной беременностью
The article analyzes domestic and foreign publications from 2009 to 2019, found in the MEDLINE, PubMed, Embase, Web of Science database on the topic: multiple pregnancy, complications, outcomes, and
Gebeliği Sırasında Miyokard İnfarktüsü Geçiren Hastada Sezaryen İçin Anestezi Yönetimi
Bu olguda, antikoagulan kullanimi nedeni ile rejyonel anestezinin kontrendike oldugu yuksek kardiyak riskli gebede genel anstezi deneyimimizi sunmayi amacladik, gebelik surecinde akut koroner sendrom gelisme riski artar.


Cardiac output changes with phenylephrine and ephedrine infusions during spinal anesthesia for cesarean section: A randomized, double-blind trial.
Good systolic blood pressure control was attained in both groups with minimal periods of hypotension or hypertension or hypertension (SBP <80% of bSBP), and administration of ephedrine was associated with significantly more fetal acidosis.
Cardiac hemodynamics before, during and after elective cesarean section under spinal anesthesia in low-risk women
Objective:The aim of this study was to describe maternal central hemodynamic parameters before and during delivery as well at the early puerperium in healthy women undergoing elective cesarean
Continuous Invasive Blood Pressure and Cardiac Output Monitoring during Cesarean Delivery: A Randomized, Double-blind Comparison of Low-dose versus High-dose Spinal Anesthesia with Intravenous Phenylephrine or Placebo Infusion
Low-dose bupivacaine (with sufentanil), combined with a low-dose infusion of phenylephrine and moderate cohydration, gives the best hemodynamic stability during spinal anesthesia for cesarean delivery.
Continuous measurement of cardiac output with the electrical velocimetry method in patients under spinal anesthesia for cesarean delivery
Continuous CO monitoring with EV enables clinicians to determine CO and SV changes prior to onset of hypotension and to better understand patients’ hemodynamics, an important addition to the current monitoring.
The Dose-Dependent Effects of Phenylephrine for Elective Cesarean Delivery Under Spinal Anesthesia
By infusing a higher concentration (100 &mgr;g/min), this study subjects the mother and fetus to a much higher dose of phenylephrine, with significant effects on maternal HR and CO, and future investigation is required to determine whether this reduction in maternal CO has detrimental effects when providing anesthesia for an emergency cesarean delivery for a compromised fetus.
Maternal hemodynamic monitoring in obstetric anesthesia.
Noninvasive methods of cardiac output measurement used in obstetric anesthesia have provided valuable information on maternal and fetal well-being and hemodynamics in the critical care setting and during regional anesthesia for cesarean delivery, and the ability to predict ventricular preload response is now recognized in the nonobstetric population.
Hemodynamic Effects of Ephedrine, Phenylephrine, and the Coadministration of Phenylephrine with Oxytocin during Spinal Anesthesia for Elective Cesarean Delivery
Bolus phenylephrine reduced maternal CO, and decreased CO when compared with ephedrine during elective spinal anesthesia for Cesarean delivery, emphasizing the importance of heart rate as a surrogate indicator of CO.
Comparison of phenylephrine infusion regimens for maintaining maternal blood pressure during spinal anaesthesia for Caesarean section.
For optimal management, phenylephrine should be titrated to maintain maternal BP at near-baseline values.
Is It More Informative to Focus on Cardiac Output than Blood Pressure during Spinal Anesthesia for Cesarean Delivery in Women with Severe Preeclampsia?
SEVERAL authors have focused on change in blood pressure as the key hemodynamic variable during neuraxial anesthesia for cesarean delivery in patients with severe preeclampsia. The optimal anesthetic
Maternal hemodynamics in late gestation and immediate postpartum in singletons vs. twin pregnancies
Hemodynamic parameters immediately before, during and shortly after CS in singleton and twin pregnancies are equivalent, and further evaluations of the value of NICaS™ in assessing cardiovascular-related pregnancy complications are warranted.