HEMODYNAMIC MANAGEMENT IN CESAREAN SECTION: CONTINUOUS VS INTERMITTENT NON-INVASIVE ARTERIAL PRESSURE MEASUREMENTS
Abstract Number: F-36
Abstract Type: Original Research
An inconsistency of hypotension detection in women undergoing cesarean section with use of standard intermittent blood pressure monitoring versus with use of a continuous non-invasive arterial pressure device post spinal anesthetic has been previously noted (1). Although hypotension was significantly more often detected while utilizing continuous non-invasive monitoring, no associated study has evaluated the potential clinical implications regarding the total hemodynamic management between these two modalities.
Evaluate the clinical management of patients undergoing cesarean section with regard to fluid and pressor administration in the setting of intermittent vs continuous non-invasive blood pressure monitoring.
A total of 56 singleton parturients undergoing cesarean section under a spinal anesthetic were included in the study analysis. Blood pressure of one group of 28 subjects were assessed via a standard intermittent blood pressure cuff, while the other 28 subjects were assessed via a continuous non-invasive blood pressure device. No specific protocol for fluid management was utilized. Fluid administration (crystalloid and colloid), fluid equivalence administration based upon a conventional 3:1 colloid to crystalloid ratio, estimated blood loss (EBL), urine output (UOP), and vasoactive medication use (phenylephrine and ephedrine) were compared between the two groups.
Total volume loss were non-significant between groups. No significant differences were identified between total fluid administration, fluid equivalence administration, and total vasoactive medication use.
Although continuous arterial pressure monitoring may detect hypotensive episodes more often than a traditional blood pressure cuff, our study suggests that no total hemodynamic management changes are demonstrated throughout an entire cesarean delivery when comparing the two.
C. Ilies, H. Kiskalt, D. Siedenhans, P. Meybohm, M. Steinfath, B. Bein, R. Hanss. Detection of hypotension during Caesarean section with continuous non-invasive arterial pressure device or intermittent oscillometric arterial pressure measurement. Br J Anaesth. 2012 Sep; 109(3): 413–419.