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Anesthetic management in parturients with chronic kidney disease undergoing elective Caesarean delivery: Our experience of nine cases.

Modi MP, Vora KS, Parikh GP, Shah VR, Misra VV, Jasani AF - Indian J Nephrol (2014)

Bottom Line: Hemodynamics and side effects such as nausea, vomiting, headache, and backache were record.Parturients with CKD with normal coagulation profile remained hemodynamically stable under spinal anesthesia with minimal side effects.However, a large number of studies are required to determine the safety of spinal anesthesia in this setting.

View Article: PubMed Central - PubMed

Affiliation: Department of Anaesthesia and Critical Care, G. R. Doshi and K. M. Mehta Institute of Kidney Diseases and Research Centre and Dr. H. L. Trivedi Institute of Transplantation Sciences, Asarwa, Ahmedabad, Gujarat, India.

ABSTRACT
In this retrospective study, we describe the anesthetic management and its implications in parturients with chronic kidney disease (CKD; n = 9), who underwent elective caesarean delivery. Nine parturients with CKD of various etiologies, who underwent elective Caesarean delivery, were included in this study. Spinal anest-hesia was administered in all parturients with normal coagulation profile through a 25-gauze spinal needle (Quincke) with 0.5% (H) bupivacaine in L2-3 space and T6 level was achieved. Hemodynamics and side effects such as nausea, vomiting, headache, and backache were record. The mean age was 28.22 ± 4.43 years. The mean levels of serum creatinine and serum potassium were 2.78 ± 1.29 mg/dl and 4.11 ± 0.46 meq/l, respectively. Mean baseline values of systolic blood pressure, diastolic blood pressure, and pulse rate were higher which decreased after spinal anesthesia. However, the incidence of hypotension, which required mephentermine treatment, was 11.1%. One patient had symptoms of nausea and vomiting/dizziness at the time of hypotension, which disappeared after treatment with 5 mg of intravenous mephentermine. Baseline value of PR remained high throughout the operation. Parturients with CKD with normal coagulation profile remained hemodynamically stable under spinal anesthesia with minimal side effects. However, a large number of studies are required to determine the safety of spinal anesthesia in this setting.

No MeSH data available.


Related in: MedlinePlus

Mean diastolic pressures after spinal anesthesia
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Figure 3: Mean diastolic pressures after spinal anesthesia

Mentions: The mean value of Hb was 10.1 ± 0.78 g/dl%. Three patients were on antihypertensive therapy: Methyldopa and nifedepine tablets. BP and PR values were shown in Figures 1-3. Mean baseline values of SBP and DBP were higher which decreased after spinal anesthesia However, the magnitude of decrease in BP was small. The incidence of hypotension, which required mephentermine treatment, was 11.1%. One patient had symptoms of nausea, vomiting, or dizziness at the time of hypotension, which disappeared after treatment with 5 mg of injection mephentermine. Baseline value of PR remained high throughout the operation. The mean values of serum creatinine and serum potassium K+ were 2.78 ± 1.29 mg% and 4.11 ± 0.46 meq/l, respectively. None of our patients had backache or headache.


Anesthetic management in parturients with chronic kidney disease undergoing elective Caesarean delivery: Our experience of nine cases.

Modi MP, Vora KS, Parikh GP, Shah VR, Misra VV, Jasani AF - Indian J Nephrol (2014)

Mean diastolic pressures after spinal anesthesia
© Copyright Policy - open-access
Related In: Results  -  Collection

License
Show All Figures
getmorefigures.php?uid=PMC3927185&req=5

Figure 3: Mean diastolic pressures after spinal anesthesia
Mentions: The mean value of Hb was 10.1 ± 0.78 g/dl%. Three patients were on antihypertensive therapy: Methyldopa and nifedepine tablets. BP and PR values were shown in Figures 1-3. Mean baseline values of SBP and DBP were higher which decreased after spinal anesthesia However, the magnitude of decrease in BP was small. The incidence of hypotension, which required mephentermine treatment, was 11.1%. One patient had symptoms of nausea, vomiting, or dizziness at the time of hypotension, which disappeared after treatment with 5 mg of injection mephentermine. Baseline value of PR remained high throughout the operation. The mean values of serum creatinine and serum potassium K+ were 2.78 ± 1.29 mg% and 4.11 ± 0.46 meq/l, respectively. None of our patients had backache or headache.

Bottom Line: Hemodynamics and side effects such as nausea, vomiting, headache, and backache were record.Parturients with CKD with normal coagulation profile remained hemodynamically stable under spinal anesthesia with minimal side effects.However, a large number of studies are required to determine the safety of spinal anesthesia in this setting.

View Article: PubMed Central - PubMed

Affiliation: Department of Anaesthesia and Critical Care, G. R. Doshi and K. M. Mehta Institute of Kidney Diseases and Research Centre and Dr. H. L. Trivedi Institute of Transplantation Sciences, Asarwa, Ahmedabad, Gujarat, India.

ABSTRACT
In this retrospective study, we describe the anesthetic management and its implications in parturients with chronic kidney disease (CKD; n = 9), who underwent elective caesarean delivery. Nine parturients with CKD of various etiologies, who underwent elective Caesarean delivery, were included in this study. Spinal anest-hesia was administered in all parturients with normal coagulation profile through a 25-gauze spinal needle (Quincke) with 0.5% (H) bupivacaine in L2-3 space and T6 level was achieved. Hemodynamics and side effects such as nausea, vomiting, headache, and backache were record. The mean age was 28.22 ± 4.43 years. The mean levels of serum creatinine and serum potassium were 2.78 ± 1.29 mg/dl and 4.11 ± 0.46 meq/l, respectively. Mean baseline values of systolic blood pressure, diastolic blood pressure, and pulse rate were higher which decreased after spinal anesthesia. However, the incidence of hypotension, which required mephentermine treatment, was 11.1%. One patient had symptoms of nausea and vomiting/dizziness at the time of hypotension, which disappeared after treatment with 5 mg of intravenous mephentermine. Baseline value of PR remained high throughout the operation. Parturients with CKD with normal coagulation profile remained hemodynamically stable under spinal anesthesia with minimal side effects. However, a large number of studies are required to determine the safety of spinal anesthesia in this setting.

No MeSH data available.


Related in: MedlinePlus