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Year : 2013  |  Volume : 59  |  Issue : 2  |  Page : 121-126

Changing trends in the management of hypotension following spinal anesthesia in cesarean section

1 Department of Anesthesiology, Critical Care and Pain Medicine, NEIGRIHMS, Shillong, Meghalaya, India
2 Department of Obstetrics and Gynecology, College of Medicine and JNM Hospital, Kalyani, Nadia, West Bengal, India

Correspondence Address:
J K Mitra
Department of Anesthesiology, Critical Care and Pain Medicine, NEIGRIHMS, Shillong, Meghalaya
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Source of Support: None, Conflict of Interest: None

DOI: 10.4103/0022-3859.113840

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Hypotension during cesarean section under spinal anesthesia remains a frequent scenario in obstetric practice. A number of factors play a role in altering the incidence and severity of hypotension. Counteracting aortocaval compression does not significantly prevent hypotension in most singleton pregnancies. Intravenous crystalloid pre-hydration is not very efficient. Thus, the focus has changed toward co-hydration and use of colloids. Among vasopressors, phenylephrine is now established as a first line drug, although there is limited data in high-risk patients. Though ephedrine crosses the placenta more than phenylephrine and can possibly cause alterations in the fetal physiology, it has not been shown to affect the fetal Apgar or neurobehavioral scores.


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Online since 12th February '04
2004 - Journal of Postgraduate Medicine
Official Publication of the Staff Society of the Seth GS Medical College and KEM Hospital, Mumbai, India
Published by Wolters Kluwer - Medknow