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British Journal of Anaesthesia, 2004, Vol. 92, No. 4 459-461
© 2004 The Board of Management and Trustees of the British Journal of Anaesthesia

Editorial I

Spinal anaesthesia for Caesarean delivery: keep the pressure up and don’t spare the vasoconstrictors

E. T. Riley

The first 150 words of the full text of this article appear below.

My prediction is that within the next few years we will be treating hypotension after spinal anaesthesia in a fundamentally different way than we have during the last 20 years. We will no longer use ephedrine as the mainstay of treatment, we will be more aggressive about maintaining arterial pressure near normal, and we will worry less (if at all) about the liberal use of other vasoconstricting drugs. In another important contribution by this group, Kee and colleagues1 provide evidence that will help us determine the optimal way for preventing the detrimental effects of maternal hypotension after induction of spinal anaesthesia for Caesarean delivery. In this study, the authors maintained maternal arterial pressure at 80%, 90% or 100% of baseline. Using umbilical artery pH as their primary outcome, they found that maintaining the arterial pressure at 100% of baseline was associated with the best outcome for the baby (highest umbilical . . . [Full Text of this Article]


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