Severe preeclampsia: hemodynamic effects of lumbar epidural anesthesia
The hemodynamic effects of lumbar epidural anesthesia (LEA) were evaluated in 11 patients with severe preeclampsia. All patients were receiving magnesium sulfate upon entry into the study. Hemodynamic measurements were obtained before and after LEA, at delivery, and 2 hr postpartum. Lumbar epidural...
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| Veröffentlicht in: | Anesthesia and analgesia 1986, Vol.65 (1), p.31-36 |
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| container_title | Anesthesia and analgesia |
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| creator | NEWSOME, L. R BRAMWELL, R. S CURLING, P. E |
| description | The hemodynamic effects of lumbar epidural anesthesia (LEA) were evaluated in 11 patients with severe preeclampsia. All patients were receiving magnesium sulfate upon entry into the study. Hemodynamic measurements were obtained before and after LEA, at delivery, and 2 hr postpartum. Lumbar epidural anesthesia significantly reduced mean arterial pressure from 121.4 mm Hg to 97.7 mm Hg, without altering cardiac index, pulmonary vascular resistance, central venous pressure (CVP), or pulmonary capillary wedge pressure (PCWP). There was a slight but statistically insignificant decrease in systemic vascular resistance from 1078 to 900.7 dynes X sec X cm-5. Cardiac index and left ventricular stroke work index were elevated in these patients, suggesting hyperdynamic left ventricular function. There was poor correlation between PCWP and CVP in several patients. We conclude that LEA may be used safely in severe preeclamptic patients and that pulmonary arterial catheters may help guide appropriate therapy in preeclamptic patients with cardiac failure or oliguria refractory to modest fluid challenges. |
| doi_str_mv | 10.1213/00000539-198601000-00005 |
| format | Article |
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There was poor correlation between PCWP and CVP in several patients. We conclude that LEA may be used safely in severe preeclamptic patients and that pulmonary arterial catheters may help guide appropriate therapy in preeclamptic patients with cardiac failure or oliguria refractory to modest fluid challenges.</description><identifier>ISSN: 0003-2999</identifier><identifier>EISSN: 1526-7598</identifier><identifier>DOI: 10.1213/00000539-198601000-00005</identifier><identifier>PMID: 3940467</identifier><identifier>CODEN: AACRAT</identifier><language>eng</language><publisher>Hagerstown, MD: Lippincott</publisher><subject>Adult ; Anesthesia ; Anesthesia depending on type of surgery ; Anesthesia, Epidural ; Anesthesia. Intensive care medicine. Transfusions. Cell therapy and gene therapy ; Biological and medical sciences ; Blood Pressure ; Female ; Gestational Age ; Hemodynamics ; Humans ; Medical sciences ; Pre-Eclampsia - physiopathology ; Pregnancy ; Pulmonary Edema - physiopathology ; Stroke Volume ; Thoracic and cardiovascular surgery. 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E</creatorcontrib><title>Severe preeclampsia: hemodynamic effects of lumbar epidural anesthesia</title><title>Anesthesia and analgesia</title><addtitle>Anesth Analg</addtitle><description>The hemodynamic effects of lumbar epidural anesthesia (LEA) were evaluated in 11 patients with severe preeclampsia. All patients were receiving magnesium sulfate upon entry into the study. Hemodynamic measurements were obtained before and after LEA, at delivery, and 2 hr postpartum. Lumbar epidural anesthesia significantly reduced mean arterial pressure from 121.4 mm Hg to 97.7 mm Hg, without altering cardiac index, pulmonary vascular resistance, central venous pressure (CVP), or pulmonary capillary wedge pressure (PCWP). There was a slight but statistically insignificant decrease in systemic vascular resistance from 1078 to 900.7 dynes X sec X cm-5. Cardiac index and left ventricular stroke work index were elevated in these patients, suggesting hyperdynamic left ventricular function. There was poor correlation between PCWP and CVP in several patients. We conclude that LEA may be used safely in severe preeclamptic patients and that pulmonary arterial catheters may help guide appropriate therapy in preeclamptic patients with cardiac failure or oliguria refractory to modest fluid challenges.</description><subject>Adult</subject><subject>Anesthesia</subject><subject>Anesthesia depending on type of surgery</subject><subject>Anesthesia, Epidural</subject><subject>Anesthesia. Intensive care medicine. Transfusions. Cell therapy and gene therapy</subject><subject>Biological and medical sciences</subject><subject>Blood Pressure</subject><subject>Female</subject><subject>Gestational Age</subject><subject>Hemodynamics</subject><subject>Humans</subject><subject>Medical sciences</subject><subject>Pre-Eclampsia - physiopathology</subject><subject>Pregnancy</subject><subject>Pulmonary Edema - physiopathology</subject><subject>Stroke Volume</subject><subject>Thoracic and cardiovascular surgery. 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Cell therapy and gene therapy</topic><topic>Biological and medical sciences</topic><topic>Blood Pressure</topic><topic>Female</topic><topic>Gestational Age</topic><topic>Hemodynamics</topic><topic>Humans</topic><topic>Medical sciences</topic><topic>Pre-Eclampsia - physiopathology</topic><topic>Pregnancy</topic><topic>Pulmonary Edema - physiopathology</topic><topic>Stroke Volume</topic><topic>Thoracic and cardiovascular surgery. Cardiopulmonary bypass</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>NEWSOME, L. R</creatorcontrib><creatorcontrib>BRAMWELL, R. S</creatorcontrib><creatorcontrib>CURLING, P. 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E</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>Severe preeclampsia: hemodynamic effects of lumbar epidural anesthesia</atitle><jtitle>Anesthesia and analgesia</jtitle><addtitle>Anesth Analg</addtitle><date>1986</date><risdate>1986</risdate><volume>65</volume><issue>1</issue><spage>31</spage><epage>36</epage><pages>31-36</pages><issn>0003-2999</issn><eissn>1526-7598</eissn><coden>AACRAT</coden><abstract>The hemodynamic effects of lumbar epidural anesthesia (LEA) were evaluated in 11 patients with severe preeclampsia. All patients were receiving magnesium sulfate upon entry into the study. Hemodynamic measurements were obtained before and after LEA, at delivery, and 2 hr postpartum. Lumbar epidural anesthesia significantly reduced mean arterial pressure from 121.4 mm Hg to 97.7 mm Hg, without altering cardiac index, pulmonary vascular resistance, central venous pressure (CVP), or pulmonary capillary wedge pressure (PCWP). There was a slight but statistically insignificant decrease in systemic vascular resistance from 1078 to 900.7 dynes X sec X cm-5. Cardiac index and left ventricular stroke work index were elevated in these patients, suggesting hyperdynamic left ventricular function. There was poor correlation between PCWP and CVP in several patients. We conclude that LEA may be used safely in severe preeclamptic patients and that pulmonary arterial catheters may help guide appropriate therapy in preeclamptic patients with cardiac failure or oliguria refractory to modest fluid challenges.</abstract><cop>Hagerstown, MD</cop><pub>Lippincott</pub><pmid>3940467</pmid><doi>10.1213/00000539-198601000-00005</doi><tpages>6</tpages></addata></record> |
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| ispartof | Anesthesia and analgesia, 1986, Vol.65 (1), p.31-36 |
| issn | 0003-2999 1526-7598 |
| language | eng |
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| source | MEDLINE; Journals@Ovid LWW Legacy Archive; Journals@Ovid Complete; EZB-FREE-00999 freely available EZB journals |
| subjects | Adult Anesthesia Anesthesia depending on type of surgery Anesthesia, Epidural Anesthesia. Intensive care medicine. Transfusions. Cell therapy and gene therapy Biological and medical sciences Blood Pressure Female Gestational Age Hemodynamics Humans Medical sciences Pre-Eclampsia - physiopathology Pregnancy Pulmonary Edema - physiopathology Stroke Volume Thoracic and cardiovascular surgery. Cardiopulmonary bypass |
| title | Severe preeclampsia: hemodynamic effects of lumbar epidural anesthesia |
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