Severe Preeclampsia: Hemodynamic Effect Of Lumbar Epidural Anaesthesia
European Journal of Molecular & Clinical Medicine,
2023, Volume 10, Issue 1, Pages 1744-1750
Abstract
Aim: To determine the hemodynamic effect of lumbar epidural anaesthesia in patients with Severe preeclampsia.Material and methods: Following approval from the institutional ethics committee, 50 non-laboring ASA (physical status I or II, age 18-32 years, weight 44-68 kg) parturients carrying a singleton pregnancy and scheduled for elective caesarean section were included in our study, and written informed consent was obtained from each parturient in their own language. There were 25 normotensive women (Group I) and 25 severe pre-eclamptic women (Group II) with blood pressures of 160/110 who needed antihypertensive medication (either nifedipine, 10–20 mg BD or TDS, or labetalol, 800–1200 mg in 2 to 3 divided doses).
Results: Parturients in both groups were equivalent in terms of age, weight, height, and foetal gestational age. The pre-eclamptic group had greater baseline SBP, DBP, and MAP. The mean baseline HR was similar in both groups. Following SAB, SBP, DBP, and MAP all declined from baseline in both groups, but the lowest recorded SBP, DBP, and MAP in the normotensive group were lower than in the parturients with pre-eclampsia, which was statistically significant. The pre-eclamptic group consumed considerably less phenylephrine than the normotensive group. The percentage of decline in DBP and MAP estimated from the baseline was likewise lower in the pre-eclamptic group (34% and 32% in normotensive, respectively, against 30% and 32% in pre-eclamptics). Pre-eclamptics required considerably less phenylephrine to cure hypotension (150.99±61 g in normotensive patients vs 50.11±22.36 g in pre-eclamptics), which was statistically significant (P <0.0001).
Conclusion: In conclusion, hypotension after spinal anaesthesia for caesarean delivery was much lower in severe pre-eclamptics than in healthy pregnant women in the current research. Furthermore, pre-eclamptic parturients had lower phenylephrine needs, and newborn outcomes were equivalent across the two groups.
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