Anesthetic management in parturients with chronic kidney disease undergoing elective Caesarean delivery: Our experience of nine cases
In this retrospective study, we describe the anesthetic management and its implications in parturients with chronic kidney disease (CKD; n = 9), who underwent elective caesarean delivery. Nine parturients with CKD of various etiologies, who underwent elective Caesarean delivery, were included in thi...
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| Veröffentlicht in: | Indian journal of nephrology 2014-01, Vol.24 (1), p.20-23 |
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| creator | Modi, M Vora, K Parikh, G Shah, V Misra, V Jasani, A |
| description | In this retrospective study, we describe the anesthetic management and its implications in parturients with chronic kidney disease (CKD; n = 9), who underwent elective caesarean delivery. Nine parturients with CKD of various etiologies, who underwent elective Caesarean delivery, were included in this study. Spinal anest-hesia was administered in all parturients with normal coagulation profile through a 25-gauze spinal needle (Quincke) with 0.5% (H) bupivacaine in L2-3 space and T6 level was achieved. Hemodynamics and side effects such as nausea, vomiting, headache, and backache were record. The mean age was 28.22 ± 4.43 years. The mean levels of serum creatinine and serum potassium were 2.78 ± 1.29 mg/dl and 4.11 ± 0.46 meq/l, respectively. Mean baseline values of systolic blood pressure, diastolic blood pressure, and pulse rate were higher which decreased after spinal anesthesia. However, the incidence of hypotension, which required mephentermine treatment, was 11.1%. One patient had symptoms of nausea and vomiting/dizziness at the time of hypotension, which disappeared after treatment with 5 mg of intravenous mephentermine. Baseline value of PR remained high throughout the operation. Parturients with CKD with normal coagulation profile remained hemodynamically stable under spinal anesthesia with minimal side effects. However, a large number of studies are required to determine the safety of spinal anesthesia in this setting. |
| doi_str_mv | 10.4103/0971-4065.125051 |
| format | Article |
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Nine parturients with CKD of various etiologies, who underwent elective Caesarean delivery, were included in this study. Spinal anest-hesia was administered in all parturients with normal coagulation profile through a 25-gauze spinal needle (Quincke) with 0.5% (H) bupivacaine in L2-3 space and T6 level was achieved. Hemodynamics and side effects such as nausea, vomiting, headache, and backache were record. The mean age was 28.22 ± 4.43 years. The mean levels of serum creatinine and serum potassium were 2.78 ± 1.29 mg/dl and 4.11 ± 0.46 meq/l, respectively. Mean baseline values of systolic blood pressure, diastolic blood pressure, and pulse rate were higher which decreased after spinal anesthesia. However, the incidence of hypotension, which required mephentermine treatment, was 11.1%. One patient had symptoms of nausea and vomiting/dizziness at the time of hypotension, which disappeared after treatment with 5 mg of intravenous mephentermine. Baseline value of PR remained high throughout the operation. Parturients with CKD with normal coagulation profile remained hemodynamically stable under spinal anesthesia with minimal side effects. However, a large number of studies are required to determine the safety of spinal anesthesia in this setting.</description><identifier>ISSN: 0971-4065</identifier><identifier>EISSN: 1998-3662</identifier><identifier>DOI: 10.4103/0971-4065.125051</identifier><identifier>PMID: 24574626</identifier><language>eng</language><publisher>India: Medknow Publications</publisher><subject>Acids ; Anesthesia ; Back pain ; Blood platelets ; Care and treatment ; Cesarean section ; Chronic kidney failure ; Diagnosis ; Fetuses ; Fluids ; Health aspects ; Kidney diseases ; Medical treatment ; Metabolites ; Original ; Patient outcomes ; Patients ; Potassium ; Pregnancy ; Skin ; Statistical analysis ; Surgery ; Vitamin deficiency</subject><ispartof>Indian journal of nephrology, 2014-01, Vol.24 (1), p.20-23</ispartof><rights>COPYRIGHT 2014 Medknow Publications and Media Pvt. Ltd.</rights><rights>Copyright Medknow Publications & Media Pvt Ltd Jan 2014</rights><rights>Copyright: © Indian Journal of Nephrology 2014</rights><lds50>peer_reviewed</lds50><oa>free_for_read</oa><woscitedreferencessubscribed>false</woscitedreferencessubscribed><citedby>FETCH-LOGICAL-c495t-6851e6cf0cdfe426c25fdef505e83c44c42c150b477d509770f86cd9357db8743</citedby><cites>FETCH-LOGICAL-c495t-6851e6cf0cdfe426c25fdef505e83c44c42c150b477d509770f86cd9357db8743</cites></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><linktopdf>$$Uhttps://www.ncbi.nlm.nih.gov/pmc/articles/PMC3927185/pdf/$$EPDF$$P50$$Gpubmedcentral$$Hfree_for_read</linktopdf><linktohtml>$$Uhttps://www.ncbi.nlm.nih.gov/pmc/articles/PMC3927185/$$EHTML$$P50$$Gpubmedcentral$$Hfree_for_read</linktohtml><link.rule.ids>230,314,724,777,781,882,4010,27439,27904,27905,27906,53772,53774</link.rule.ids><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/24574626$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><creatorcontrib>Modi, M</creatorcontrib><creatorcontrib>Vora, K</creatorcontrib><creatorcontrib>Parikh, G</creatorcontrib><creatorcontrib>Shah, V</creatorcontrib><creatorcontrib>Misra, V</creatorcontrib><creatorcontrib>Jasani, A</creatorcontrib><title>Anesthetic management in parturients with chronic kidney disease undergoing elective Caesarean delivery: Our experience of nine cases</title><title>Indian journal of nephrology</title><addtitle>Indian J Nephrol</addtitle><description>In this retrospective study, we describe the anesthetic management and its implications in parturients with chronic kidney disease (CKD; n = 9), who underwent elective caesarean delivery. Nine parturients with CKD of various etiologies, who underwent elective Caesarean delivery, were included in this study. Spinal anest-hesia was administered in all parturients with normal coagulation profile through a 25-gauze spinal needle (Quincke) with 0.5% (H) bupivacaine in L2-3 space and T6 level was achieved. Hemodynamics and side effects such as nausea, vomiting, headache, and backache were record. The mean age was 28.22 ± 4.43 years. The mean levels of serum creatinine and serum potassium were 2.78 ± 1.29 mg/dl and 4.11 ± 0.46 meq/l, respectively. Mean baseline values of systolic blood pressure, diastolic blood pressure, and pulse rate were higher which decreased after spinal anesthesia. However, the incidence of hypotension, which required mephentermine treatment, was 11.1%. One patient had symptoms of nausea and vomiting/dizziness at the time of hypotension, which disappeared after treatment with 5 mg of intravenous mephentermine. Baseline value of PR remained high throughout the operation. Parturients with CKD with normal coagulation profile remained hemodynamically stable under spinal anesthesia with minimal side effects. However, a large number of studies are required to determine the safety of spinal anesthesia in this setting.</description><subject>Acids</subject><subject>Anesthesia</subject><subject>Back pain</subject><subject>Blood platelets</subject><subject>Care and treatment</subject><subject>Cesarean section</subject><subject>Chronic kidney failure</subject><subject>Diagnosis</subject><subject>Fetuses</subject><subject>Fluids</subject><subject>Health aspects</subject><subject>Kidney diseases</subject><subject>Medical treatment</subject><subject>Metabolites</subject><subject>Original</subject><subject>Patient outcomes</subject><subject>Patients</subject><subject>Potassium</subject><subject>Pregnancy</subject><subject>Skin</subject><subject>Statistical analysis</subject><subject>Surgery</subject><subject>Vitamin deficiency</subject><issn>0971-4065</issn><issn>1998-3662</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2014</creationdate><recordtype>article</recordtype><sourceid>8G5</sourceid><sourceid>ABUWG</sourceid><sourceid>AFKRA</sourceid><sourceid>AZQEC</sourceid><sourceid>BENPR</sourceid><sourceid>CCPQU</sourceid><sourceid>DWQXO</sourceid><sourceid>GNUQQ</sourceid><sourceid>GUQSH</sourceid><sourceid>M2O</sourceid><recordid>eNptkl2LEzEUhgdR3HX13isJCOLN1CSTzIcXC6X4BQt7o9chTc50sp1JajKztT_A_-0p3a2tSC5Ckue8J-_hzbLXjM4Eo8UH2lQsF7SUM8YllexJdsmaps6LsuRPs8vj80X2IqU7SrkUjXyeXXAhK1Hy8jL7PfeQxg5GZ8igvV7BAH4kzpONjuMUHZ4S2bqxI6aLwSO2dtbDjliXQCcgk7cQV8H5FYEezOjugSw0JB1Be2Khx4u4-0hup0jg1wb2kgZIaIl3HohBjfQye9bqPsGrh_0q-_H50_fF1_zm9su3xfwmN_jvMS9ryaA0LTW2BcFLw2VroUXnUBdGCCO4YZIuRVVZieYr2talsU0hK7usK1FcZdcH3c20HMAaNBd1rzbRDTruVNBOnb9416lVuFdFwytWSxR4_yAQw88JJ6cGlwz0vfYQpqSweyEFY6xA9O0_6F2Yokd7iqGbhhecNn-ple5BOd8G7Gv2omqO3xZNxVmN1Ow_FC4LgzPBQ-vw_qzg3UlBB7ofuxT6aXTBp3OQHkATQ0oR2uMwGFX7jKl9iNQ-ROqQMSx5czrEY8FjqBCYH4Bt6EeIad1PW4gK2bUP2zPh_ERYcaoe01j8AWO14dc</recordid><startdate>20140101</startdate><enddate>20140101</enddate><creator>Modi, M</creator><creator>Vora, K</creator><creator>Parikh, G</creator><creator>Shah, V</creator><creator>Misra, V</creator><creator>Jasani, A</creator><general>Medknow Publications</general><general>Medknow Publications and Media Pvt. 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Nine parturients with CKD of various etiologies, who underwent elective Caesarean delivery, were included in this study. Spinal anest-hesia was administered in all parturients with normal coagulation profile through a 25-gauze spinal needle (Quincke) with 0.5% (H) bupivacaine in L2-3 space and T6 level was achieved. Hemodynamics and side effects such as nausea, vomiting, headache, and backache were record. The mean age was 28.22 ± 4.43 years. The mean levels of serum creatinine and serum potassium were 2.78 ± 1.29 mg/dl and 4.11 ± 0.46 meq/l, respectively. Mean baseline values of systolic blood pressure, diastolic blood pressure, and pulse rate were higher which decreased after spinal anesthesia. However, the incidence of hypotension, which required mephentermine treatment, was 11.1%. One patient had symptoms of nausea and vomiting/dizziness at the time of hypotension, which disappeared after treatment with 5 mg of intravenous mephentermine. Baseline value of PR remained high throughout the operation. Parturients with CKD with normal coagulation profile remained hemodynamically stable under spinal anesthesia with minimal side effects. However, a large number of studies are required to determine the safety of spinal anesthesia in this setting.</abstract><cop>India</cop><pub>Medknow Publications</pub><pmid>24574626</pmid><doi>10.4103/0971-4065.125051</doi><tpages>4</tpages><oa>free_for_read</oa></addata></record> |
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| source | Medknow Open Access Medical Journals; Elektronische Zeitschriftenbibliothek - Frei zugängliche E-Journals; PubMed Central |
| subjects | Acids Anesthesia Back pain Blood platelets Care and treatment Cesarean section Chronic kidney failure Diagnosis Fetuses Fluids Health aspects Kidney diseases Medical treatment Metabolites Original Patient outcomes Patients Potassium Pregnancy Skin Statistical analysis Surgery Vitamin deficiency |
| title | Anesthetic management in parturients with chronic kidney disease undergoing elective Caesarean delivery: Our experience of nine cases |
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