FETAL ACID-BASE STATE FOLLOWING SPINAL OR EPIDURAL-ANESTHESIA FOR CESAREAN-SECTION

  • 1 January 1980
    • journal article
    • research article
    • Vol. 56  (5) , 610-615
Abstract
Fetal acid-base state and maternal blood pressure response were compared in 111 women undergoing repeat cesarean section with epidural [bupivacaine, epinephrine] or spinal [lidocaine, epinephrine] anesthesia. Fetal umbilical acidemia (umbilical venous pH < 7.25 or umbilical arterial pH < 7.20) was more commonly observed following spinal anesthesia with a preanesthetic fluid load of 500-999 ml (20% of cases) than with epidural anesthesia (4% of cases, P < 0.05, .chi.2). The incidence of fetal acidemia following spinal anesthesia was similar to that following epidural anesthesia when 1000/1500 ml of fluid was infused prior to spinal anesthesia. The maximum reduction in systolic blood pressure following spinal anesthesia was not related to preanesthetic fluid load; in cases of severe hypotension, the hypotensive episode was shorter and easier to treat when the preanesthetic fluid load was 1000-1500 ml rather than 500-999 ml. Apparently, women receiving spinal anesthesia for repeat cesarean section should be given an i.v. fluid load of 1 l or more.

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