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A survey of the management of spinal-induced hypotension for scheduled cesarean delivery.

Publication ,  Journal Article
Allen, TK; Muir, HA; George, RB; Habib, AS
Published in: Int J Obstet Anesth
October 2009

BACKGROUND: Intravenous fluids and vasopressors are used for managing spinal-induced hypotension during cesarean delivery, but the choice of vasopressor and the type and timing of fluid administration remain controversial. METHODS: We conducted an electronic survey of all members of the Society for Obstetric Anesthesia and Perinatology between February and March 2007 to determine their preferences for preventing and treating spinal-induced hypotension with respect to fluid and vasopressor administration. RESULTS: The response rate was 292/746 (39%). Fifty percent worked in academic institutions and 56% had >50% of their clinical responsibility to obstetric anesthesia. For prophylaxis, 35% used fluid preloading, 30% fluid preloading with vasopressors, and 12% fluid co-loading with vasopressors. Of those using vasopressors for prophylaxis, 32% used ephedrine, 26% used phenylephrine, and 33% based their choice on heart rate. For treatment, 32% used ephedrine, 23% used phenylephrine, and 41% used either agent based on heart rate. Anesthesiologists in academic practice were less likely to use fluid preloading only (P=0.028) and more likely to use fluid co-loading and vasopressors (P=0.003). They were also more likely to administer phenylephrine for prophylaxis compared with those in private practice (P=0.042). CONCLUSION: Significant variations in practice exist in the prevention and treatment of spinal-induced hypotension. Fluid preloading and the prophylaxis and treatment of hypotension with ephedrine continue to be common practices.

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Published In

Int J Obstet Anesth

DOI

EISSN

1532-3374

Publication Date

October 2009

Volume

18

Issue

4

Start / End Page

356 / 361

Location

Netherlands

Related Subject Headings

  • Vasoconstrictor Agents
  • United Kingdom
  • Surveys and Questionnaires
  • Pregnancy
  • Phenylephrine
  • Hypotension
  • Humans
  • Health Care Surveys
  • Fluid Therapy
  • Female
 

Citation

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Chicago
ICMJE
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Allen, T. K., Muir, H. A., George, R. B., & Habib, A. S. (2009). A survey of the management of spinal-induced hypotension for scheduled cesarean delivery. Int J Obstet Anesth, 18(4), 356–361. https://doi.org/10.1016/j.ijoa.2009.03.014
Allen, T. K., H. A. Muir, R. B. George, and A. S. Habib. “A survey of the management of spinal-induced hypotension for scheduled cesarean delivery.Int J Obstet Anesth 18, no. 4 (October 2009): 356–61. https://doi.org/10.1016/j.ijoa.2009.03.014.
Allen TK, Muir HA, George RB, Habib AS. A survey of the management of spinal-induced hypotension for scheduled cesarean delivery. Int J Obstet Anesth. 2009 Oct;18(4):356–61.
Allen, T. K., et al. “A survey of the management of spinal-induced hypotension for scheduled cesarean delivery.Int J Obstet Anesth, vol. 18, no. 4, Oct. 2009, pp. 356–61. Pubmed, doi:10.1016/j.ijoa.2009.03.014.
Allen TK, Muir HA, George RB, Habib AS. A survey of the management of spinal-induced hypotension for scheduled cesarean delivery. Int J Obstet Anesth. 2009 Oct;18(4):356–361.
Journal cover image

Published In

Int J Obstet Anesth

DOI

EISSN

1532-3374

Publication Date

October 2009

Volume

18

Issue

4

Start / End Page

356 / 361

Location

Netherlands

Related Subject Headings

  • Vasoconstrictor Agents
  • United Kingdom
  • Surveys and Questionnaires
  • Pregnancy
  • Phenylephrine
  • Hypotension
  • Humans
  • Health Care Surveys
  • Fluid Therapy
  • Female