Eclampsia is a complex hypertensive disorder of pregnancy affecting multiple systems. The choice of anaesthesia in eclamptic mothers undergoing Caesarean section has been debated for years. Currently, the safety of regional anaesthesia techniques is well established and they can provide better obstetrical outcomes. Several studies have been carried out which state the benefits of spinal anaesthesia over general anaesthesia in eclampsia.
Our aim was to study the hemodynamic changes associated with spinal anaesthesia and its safety in eclamptic patients.
Methods: We carried out a retrospective study of 50 eclamptic women who underwent Lower Segment Caesarean Section (LSCS) under spinal anaesthesia in Government medical college Akola from January 2017 to July 2018. Both emergencies, as well as elective cases, were included in the study. PatientsÂ’ records were studied and analyzed and relevant information was taken into account. The drug used for spinal anaesthesia was hyperbaric Bupivacaine 0.5%. Subarachnoid block was performed in either L3-L4 or L4-L5 intervertebral segment. A spinal needle 25G bevel was used. The hemodynamic response (systolic blood pressure, diastolic blood pressure, heart rate) and SpO2 were observed.
Results: The majority of patients were young primigravida(68%). A drop in systolic and diastolic blood pressure was observed in the initial 5 and 10 minutes after spinal anaesthesia. Intraoperatively 11 patients had hypotension and 2 patients had hypertension. Heart rate fluctuations stabilized within 10 minutes and only 4 patients had bradycardia and 6 patients had tachycardia. SpO2 remained stable in all patients.
Conclusion: We concluded that considering the haemodynamic stability associated with spinal anaesthesia in eclamptic patients, it can be safely administered.
Key words: eclampsia, Caesarian section, spinal anaesthesia
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