title: Awareness and Aortocaval Obstruction in Obstetric Anesthesia.
abstract: Awareness during general anesthesia for cesarean delivery continues to be a major problem. The key to preventing awareness is strict attention to anesthetic technique. The prevalence and implications of aortocaval compression have been firmly established. Compression of the vena cava is a real occurrence when assuming the supine position. Relief of this compression most likely does not occur until the patient is turned 30°, which is not feasible for performing cesarean delivery. Although it is still wise to tilt the patient, the benefit of this tilt may not be as great as once thought.
authors.affiliation: Department of Anesthesiology and Critical Care, Hospital of the University of Pennsylvania, 3400 Spruce Street, Philadelphia, PA 19104, USA. Electronic address: Nathaniel.Hsu@uphs.upenn.edu.
authors.forename: Nathaniel
authors.initials: N
authors.lastname: Hsu
authors.affiliation: Department of Anesthesiology, University of Kentucky, Lexington, KY 40506, USA.
authors.forename: Robert R
authors.initials: RR
authors.lastname: Gaiser
mesh_terms: D000773:Anesthesia, Obstetrical; D001012:Aorta, Abdominal / Q000503:physiopathology*; D003251:Constriction, Pathologic / Q000517:prevention & control; D005260:Female; D006801:Humans; D058926:Intraoperative Awareness / Q000517:prevention & control*; D007744:Obstetric Labor Complications / Q000517:prevention & control*; D056888:Patient Positioning; D011187:Posture; D011247:Pregnancy; D012307:Risk Factors; D014684:Venae Cavae / Q000503:physiopathology*
keywords: Aortocaval compression; Awareness; Cesarean delivery; General anesthesia; Hypotension