Spinal Anesthesia in Severe Preeclampsia

  title={Spinal Anesthesia in Severe Preeclampsia},
  author={V Henke and Brian T. Bateman and Lisa Leffert},
of hypotension after spinal anesthesia among severely preeclamptic parturients exclude patients in active labor because labor itself attenu-ates the frequency and severity of the hypotensive response to neuraxial anesthesia during cesarean delivery. Most studies are relatively small ( n < 150), and the details of preoperative antihypertensive and magnesium regimens vary. Three prospective trials have demonstrated that preeclamptic parturients experience less frequent and less severe hypotension… 


Incidence of hypotension after spinal anaesthesia was less frequent and less severe in preeclampsia patients and required lower dose of ephedrine than normotensive population and there was increased incidence of headache and blurring of vision among severe preeclamped patients.

Outcome of Spinal Anesthesia during Emergency Cesarean Section for Severe Preeclampsia and Eclampsia Patients in a Tertiary Care Hospital

1. Associate Professor, Department of Anesthesiology & Intensive Care Unit (ICU) Enam Medical College & Hospital Savar, Dhaka, and Associate Professor of Gynecology & Obstetrics, Enam medical College and Hospital, Savar.

Spinal induced hypotension in pre-eclamptic and healthy parturients

The incidence of spinal-induced hypotension associated with patients undergoing C-Section is more in preeclamptic than in healthy parturients, according to a study of 60 pregnant patients undergoing a C- section with spinal anesthesia.

Comparative Dose-Response Study of Phenylephrine Bolus for the Treatment of the First Episode of Spinal Anesthesia-Induced Hypotension for Cesarean Delivery in Severe Preeclamptic versus Normotensive Parturients

Under this study conditions, severe preeclamptic parturients required a 34% reduction of ED50 of phenylephrine dose compared with normotensive parturient.

Type of obstetric anesthesia administered and complications in women with preeclampsia in low- and middle-income countries: A systematic review

General anesthesia is associated with increased complications in women with preeclampsia undergoing cesarean section in LMIC, and the association between outcomes and type of anesthesia is summarized using a random effects model.

Anesthetic Considerations in Preeclampsia

In pregnant women with preeclampsia spinal and epidural anesthesia can be useful during caesarean section, and Epidural anesthesia in properly indicated cases provides safe and effective pain relief.

Prophylactic Ondansetron Does Not Prevent Shivering or Decrease Shivering Severity During Cesarean Delivery Under Combined Spinal Epidural Anesthesia: A Randomized Trial

Intravenous ondansetron 8 mg before performing CSE anesthesia in women undergoing elective cesarean delivery does not decrease the incidence or severity of shivering.

Intraoperative requirement of Phenylephrine for spinal anaesthesia, with comparison of hemodynamic parameters between severe pre-eclamptic and normotensive parturients for elective caesarean section: A prospective study

There was statistically less hypotension following spinal anaesthesia and less requirement of vasopressor in pre-eclamptic as compared to normotensive parturients, and the mean requirement of Phenylephrine to manage this hypotension was 156.3±62µg.

Anesthesia in severe preeclampsia

The primary peripartum goals in the severely preeclampsia parturient are the optimization of maternal blood pressure, cardiac output, and uteroplacental perfusion and the prevention of seizures and stroke.

Anesthesia Management for Emergency Cesarean Section in Patient with Severe Preeclampsia and Controlled Hyperthyroidism: A Case Report

In this case, a 32-year-old pregnant patient with severe preeclampsia and controlled hyperthyroidism was performed under spinal anesthesia using 10 mg of Bupivacaine and the operation went successfully without any complications for the mother and baby.



Spinal Anesthesia-Induced Hypotension: A Risk Comparison Between Patients with Severe Preeclampsia and Healthy Women Undergoing Preterm Cesarean Delivery

It is concluded that preeclampsia-associated factors, rather than a smaller uterine mass, account for the infrequent incidence of spinal hypotension in preeclamptic patients.

Spinal anesthesia for cesarean delivery in severely preeclamptic women: don't throw out the baby with the bathwater!

The findings of this paper resonated among anesthesiologists and obstetricians because it was performed at Parkland Hospital in Dallas, Texas, an institution that for many years taught that spinal anesthesia was absolutely contraindicated in severely preeclamptic women.

Patients with Severe Preeclampsia Experience Less Hypotension During Spinal Anesthesia for Elective Cesarean Delivery than Healthy Parturients: A Prospective Cohort Comparison

The severely preeclamptic patients had a less frequent incidence of clinically significant hypotension and required less ephedrine than healthy parturients undergoing cesarean delivery, and the risk of hypotension was almost six times less than that in healthy patients.

Spinal versus epidural anesthesia for cesarean delivery in severe preeclampsia: a prospective randomized, multicenter study.

The results of this large prospective study support the use of spinal anesthesia for cesarean delivery in severely preeclamptic patients and find that there was a statistically significant difference in MAP.

Prospective, Randomized Trial Comparing General with Spinal Anesthesia for Cesarean Delivery in Preeclamptic Patients with a Nonreassuring Fetal Heart Trace

In preeclamptic patients with a nonreassuring fetal heart trace, spinal anesthesia for cesarean delivery was associated with a greater mean neonatal umbilical arterial base deficit and a lower median umbilicals arterial pH.

Combined Spinal and Epidural Anesthesia With Low Doses of Intrathecal Bupivacaine in Women With Severe Preeclampsia: A Preliminary Report

The results indicate that CSE with low intrathecal doses of bupivacaine and epidural supplementation, when needed, produces adequate anesthesia for cesarean delivery and analgesia for labor in patients with severe preeclampsia.

A Review of the Impact of Phenylephrine Administration on Maternal Hemodynamics and Maternal and Neonatal Outcomes in Women Undergoing Cesarean Delivery Under Spinal Anesthesia

  • A. Habib
  • Medicine
    Anesthesia and analgesia
  • 2012
The effects of phenylephrine compared with ephedrine on maternal hemodynamics, heart rate, and cardiac output, and occurrence of intraoperative nausea and vomiting are highlighted.

Changes in maternal middle cerebral artery blood flow velocity associated with general anesthesia in severe preeclampsia.

The findings indicate that Vm increases significantly after rapid-sequence induction of GA and tracheal intubation in women with severe preeclampsia, and there seems to be a direct relationship between MAP and Vm.