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Comparison of Phenylephrine Bolus and Infusion Regimens on Maternal and Fetal Outcomes During Cesarean Delivery: A Systematic Review and Meta-Analysis.
Anesth Analg
December 2024
From the Department of Anaesthesiology, Pain Medicine, and Critical Care, All India Institute of Medical Sciences (AIIMS), New Delhi, India.
Background: A systematic review and meta-analysis was conducted to compare phenylephrine boluses versus prophylactic infusion in parturients undergoing cesarean delivery under spinal or combined spinal-epidural anesthesia on feto-maternal outcomes.
Methods: Medline, Embase, Cochrane, and US Clinical registry databases were searched. Studies comparing phenylephrine boluses (both therapeutic and prophylactic) with infusion (both fixed- and variable-rate) assessing various feto-maternal outcomes were included.
Complications of cerebrospinal fluid drainage in thoracoabdominal aortic procedures.
Can J Surg
December 2024
From the Cumming School of Medicine, University of Calgary, Calgary, Alta. (Krzyzaniak, Vergouwen, Van Essen, Nixon); the Department of Surgery, Section of Vascular Surgery, University of Calgary, Calgary, Alta. (Krzyzaniak, Moore, Rommens); the Department of Cardiac Sciences, Section of Cardiac Surgery, University of Calgary, Calgary, Alta. (McClure); the Calgary Aortic Program, Calgary, Alta. (McClure, Moore, Rommens); the Department of Anesthesiology, Perioperative and Pain Medicine, University of Calgary, Calgary, Alta. (Nixon, Jadavji).
Background: Cerebrospinal fluid (CSF) drainage is used to reduce spinal cord ischemia (SCI) in patients undergoing thoracoabdominal aortic procedures. Recent literature has found high rates of complication associated with CSF drainage, which has led to changes in practice. The aim of this study was to investigate rates of CSF drain-related complications in patients undergoing a thoracoabdominal aortic procedure with perioperative placement of a CSF drain.
View Article and Find Full Text PDFA Dose-Response Study of Four Fixed Weight-Based Phenylephrine Dosages in Obese Cesarean Delivery Patients to Prevent Spinal Anesthesia-Induced Hypotension.
Clin Pharmacokinet
December 2024
Department of Anesthesia, Hangzhou City Linping District Maternal and Children Care Hospital, Hangzhou, China.
Background And Objective: Reports have suggested the use of intravenous infusion of vasopressors as an approach to prevent spinal anesthesia-induced hypotension (SAIH) in women undergoing cesarean deliveries. However, data on the suitability of this technique for obese people are limited. As such, the current experiment was designed to clarify the dose-response relationship associated with the preventive administration of phenylephrine to avoid SAIH during cesarean delivery in obese parturients under combined spinal-epidural anesthesia.
View Article and Find Full Text PDFEffect of crystalloid solution co-loading infusion rate on the dose requirements of prophylactic phenylephrine for preventing hypotension following combined spinal-epidural anesthesia for cesarean delivery.
BMC Pregnancy Childbirth
November 2024
Department of Anesthesia, Jiaxing University Affiliated Women and Children Hospital, No. 2468 East Zhonghuang Road, Jiaxing city, 314050, China.
Background: Intravenous fluid administration and prophylactic vasopressor infusion are the primary methods for preventing spinal anesthesia-induced hypotension during cesarean delivery. However, evidence regarding the impact of different volumes of crystalloid solution on the phenylephrine infusion dosage for preventing this hypotension remains inconclusive. This study aimed to determine the effect of two IV fluid infusion rates (10 or 20 mL/kg/h) on phenylephrine requirement for preventing spinal anesthesia-induced hypotension.
View Article and Find Full Text PDFAnesthetic management for fetal surgery: Lessons from a single-center experience (2019-2023).
Int J Obstet Anesth
October 2024
Faculty of Medical and Health Sciences, Tel-Aviv University, Tel-Aviv, Israel; Fetal Medicine Center, Helen Schneider Hospital for Women, Rabin Medical Center, Petach Tikvah, Israel.
Fetal surgery presents distinctive anesthetic challenges due to the need to balance maternal and fetal safety. This retrospective study evaluates the anesthetic management strategies used at a single center for various fetal interventions, including fetoscopic laser photocoagulation, fetal endoluminal tracheal occlusion, bipolar cord coagulation, and fetoscopic spina bifida repair. We reviewed 195 fetal procedures performed between 2019 and 2023 at Rabin Medical Center.
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