Cardiac output in women undergoing cesarean section with epidural or general anesthesia.
Cardiac output during cesarean section and for 24 hours after delivery was estimated by using a noninvasive ultrasonic Doppler technique and was compared between term pregnant patients who underwent either epidural or general anesthesia. Cardiac output peaked by 36.7% and 26.3% of baseline values at 15 and 30 minutes after delivery, respectively, with epidural anesthesia and by 28% and 17.2%, respectively, with general anesthesia. From 60 minutes to 24 hours after delivery, cardiac output in both groups remained elevated at preoperative levels. This study demonstrates a similar pattern of increase in cardiac output with epidural and general anesthesia and a return by 60 minutes to preoperative levels, which persisted for up to 24 hours after delivery. The applicability of this noninvasive technique can be extended in various circumstances during pregnancy, labor, delivery, and the postpartum period to further define cardiac output in pregnancy.
James
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Department of Anesthesiology, University of Florida College of Medicine, Gainesville.
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D000767:Anesthesia, Epidural; D000768:Anesthesia, General; D000773:Anesthesia, Obstetrical; D001794:Blood Pressure / Q000187:drug effects; D002302:Cardiac Output / Q000187:drug effects*; D002585:Cesarean Section; D003201:Computers; D005260:Female; D006339:Heart Rate / Q000187:drug effects; D006801:Humans; D007432:Intraoperative Period; D008991:Monitoring, Physiologic / Q000379:methods; D011184:Postoperative Period; D011247:Pregnancy; D013318:Stroke Volume / Q000187:drug effects; D013997:Time Factors; D014465:Ultrasonics