Cardiovascular Alterations in the Parturient Undergoing Cesarean Delivery With Neuraxial Anesthesia

Katherine W Arendt; Jochen D Muehlschlegel; Lawrence C Tsen


Expert Rev of Obstet Gynecol. 2012;7(1):59-75. 

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Expert Commentary

Over the past 10 years, clinician-scientists have artfully performed a series of clinical studies that have assisted the clinician in preventing neuraxial anesthesia-induced hypotension. Although left uterine displacement has been utilized for decades, the mode of hydration has changed from administration of a fluid bolus prior to initiation of neuraxial anesthesia, to simply co-loading fluid as the neuraxial technique is being performed. Lower doses of intrathecal local anesthesia supplemented with opioid are now being used and phenylephrine has replaced ephedrine as the vasopressor of choice. The phenylephrine infusion regimens are now widely employed clinically, with clinicians experiencing far fewer episodes of post-neuraxial anesthesia-induced hypotension.


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