Optimization of anesthesic protection for caesarean section

Kim En-Din, A.K. Abidov, Ilkhamov A.F., B.I. Makhkamov, Ye.A. Bezschetnova, N.M. Kamalova, N.K. Shodmankulova, A.H. Atadzhanov

Abstract


Spinal anesthesia (SA) was performed in 93 women for сaesarean section. Indications for surgery were: operated uterine disease, incompetent uterine scar, cephalopelvic disproportion, high-degree myopia, secondary uterine inertia. As a local anesthetic for SA, we have used 0.5% Longocain Heavy. Preinfusion was performed with Gecoton— 3–4 ml/kg. In order to assess SA effects on central hemodynamics and preinfusion, we have studied central hemodynamics, circulating plasma volume, extracellular fluid volume; newborns were evaluated by Apgar score. It was found that intravenous preinfusion of Gecoton due to the combination of the benefits of colloid hyperosmolar component quickly causes a redistribution of fluid from the intercellular space into the intravascular one, firmly supports the volemic effect, which allows us to use smaller volume of the solution for preoperative preparation during neuraxial anesthesia. The use of Gecoton as preinfusion (3–4 ml/kg) stabilizes hemodynamic profile after SA. In 81 (87.1 %) cases, there was a relatively stable hemodynamics, which did not require adrenomimetic support, and only in 12 (12.9 %) — there was a severe hypotension, the correction of which was carried out by fractional introduction of mesaton.

Keywords


spinal anesthesia; сesarean section; hemodyna­mics; Gecoton

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DOI: https://doi.org/10.22141/2224-0586.1.80.2017.94452

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