title: Anesthetic management in parturients with chronic kidney disease undergoing elective Caesarean delivery: Our experience of nine cases.
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.
authors.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.
authors.forename: M P
authors.initials: MP
authors.lastname: Modi
authors.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.
authors.forename: K S
authors.initials: KS
authors.lastname: Vora
authors.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.
authors.forename: G P
authors.initials: GP
authors.lastname: Parikh
authors.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.
authors.forename: V R
authors.initials: VR
authors.lastname: Shah
authors.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.
authors.forename: V V
authors.initials: VV
authors.lastname: Misra
authors.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.
authors.forename: A F
authors.initials: AF
authors.lastname: Jasani
keywords: Caesarean delivery; chronic kidney disease; pregnancy; spinal anesthesia