Spinal Anesthesia in Pregnant Females with Preeclampsia

Abstract

What option of anesthesia should be preferred if there is a need for cesarean section in pregnant women with severe preeclampsia remains unanswered so far.Objective: to evaluate the safety of spinal anesthesia (SA) in pregnant women with preeclampsia.Materials and methods. Fifty four cases of spinal anesthesia during cesarean section were analyzed in pregnant females with preeclampsia. Preoperative preparation involved an occult aortocaval compression test; lower extremity strapping up to the upper third of the hip; study of central hemodynamic parameters (cardiac index, end-diastolic volume, total peripheral vascular resistance). Preoperative central hemodynamics was examined by two-dimensional echocardiography using a Shimasonic SD1 310 apparatus. Standard monitoring of blood pressure (BP), heart rate, arterial blood oxygen saturation (SpO2) was made during anesthesia, by employing a Cardiocap II CG-CS monitor (Datex). BP was measured every two minutes until the fetus was extracted and then every 5 minutes before the puerpera was transferred to a rehabilitative ward.Results. The findings disagree with the traditional view of the negative hemodynamic effects of SA in pregnant females with preeclampsia. No cases of developed arterial hypotension were revealed in the study group.Conclusion. Spinal anesthesia strategy has been proposed, which is effective in preventing hemodynamic complications when anesthetization is made during both elective and emergency cesarean sections in pregnant females with preeclampsia.

Keywords

• preeclampsia
• spinal anesthesia
• preinfusion
• central hemodynamics