[Spinal anesthesia for cesarean section--safe and effective anesthetic management].
Spinal anesthesia is a safe and effective anesthetic technique for cesarean section, considering its simplicity, rapidity, accompanied maternal awareness and distribution of anesthetic agents. The problems of spinal anesthesia, hypotension, postdural puncture headache, failed spinal anesthesia, and its duration, have been investigated. Intravenous fluid therapy may reduce the incidence and severity of the hypotension. Colloid administration is one of the interventions for prevention of hypotension. Low dose phenylephrine is effective without fetal acidosis in healthy mother. The fluid and vasoconstrictor therapies for hypotension induced by spinal anesthesia were briefly reviewed. Postdural puncture headache is one of the troublesome problems. Epidural blood patch is one of the definitive treatments; however further randomized trials are required. Spinal opioid has improved the quality of spinal anesthesia. The recommended dose of spinal opioid in the recent obstetric anesthesia textbooks has been reviewed. The recent issue about safety and effectiveness in obstetric anesthesia has been briefly discussed.
Department of Anesthesiology, Hyogo College of Medicine, Nishinomiya 663-8501.
Nobutaka
N
Kariya
Chikara
C
Tashiro
D000773:Anesthesia, Obstetrical / Q000009:adverse effects; D000775:Anesthesia, Spinal / Q000009:adverse effects; D001804:Blood Transfusion, Autologous; D002585:Cesarean Section; D005260:Female; D006801:Humans; D007024:Hypotension, Orthostatic / Q000517:prevention & control; D007431:Intraoperative Complications / Q000517:prevention & control; D010102:Oxygen Inhalation Therapy; D019990:Perioperative Care; D051299:Post-Dural Puncture Headache / Q000209:etiology / Q000628:therapy; D011183:Postoperative Complications; D011247:Pregnancy; D013577:Syndrome