Zeitschrift für Geburtshilfe und Neonatologie
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Z Geburtshilfe Neonatol · Aug 2013
Randomized Controlled TrialDo we need cephalic spread of spinal anaesthesia for caesarean section? A different approach to CSE-EVE for reducing hypotension.
Spinal anaesthesia is the most preferred anaesthetic technique for elective as well as for unplanned Caesarean sections. Spinal-induced hypotension remains the most important side effect with a reported incidence between 20% and 100%. It can cause -maternal discomfort (nausea and vomiting) and impaired utero-placental perfusion. ⋯ Both groups were comparable in demographic data, VAS scores, preloading and infusion volume, atropine or ephedrine use, and adverse effects such as nausea or skin pruritus. We demonstrated a possible restriction of the spread of spinal anaesthesia by using epidural volume restriction with 20 mL saline as part of a combined spinal epidural technique. The study shows that CSE with EVR using only 50% of the levobupivacaine dose provided adequate anaesthesia for elective Caesarean delivery, as well as better maternal haemodynamic stability.