Journal Of Emergency
ISSN 2301-7864
Vol. 2 / No. 1 / Published : 2013-07
Order : 7, and page :43 - 52
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Original Article :
Correlation between body mass indeks and incidence of hypotension on pregnant mothers undergoing caesarean section under spinal block anesthesia
Author :
- Sri Wahjoeningsih*1
- Ary Faridiansyah*2
- Dosen Fakultas Kedokteran
- Mahasiswa Fakultas Kedokteran
Abstract :
Background: Spinal block anesthesia, a regional anesthesia technique that is still widely used for the operation sectio Caesarea. The most frequent complication was hypotension caused by sympathetic block with bad effects to the mother and fetus. In pregnant arising nausea, vomiting to decreased awareness, whereas in infants can cause blood flow uteroplacental hypoperfusion affecting the transfer of oxygen and nutrients that affect fetal fetus. Actions can be done to overcome hypotension mother left lateral position, oxygen supplementation, fluid preload and prophylactic ephedrine IV / IM, but no satisfactory results. Therefore, it needs a predictive factor before intervention. Obesity is classified according to the WHO by the Body Mass Index (BMI), is suspected to be a predictive factor of hypotension on spinal block anesthesia. Methods: The study included 38 patients of pregnant women aged 20-40 years of ASA PS 1 and 2, which will be done sectio Caesarea measured BMI, systolic blood pressure, diastolic, Mean Arterial Pressure (MAP) and pulse as a baseline. Patients were given 500 ml RL for loading + 15 mins positioned further to the left oblique. Then spinal block is perform according to the procedure using Spinocan 26 G, using 5% Lidodex Adrenalin 0.2 mg + 75mg. With the target height of the block Thoracal VI-IV. The patient is positioned left lateral tilt. Measurement and recording of blood pressure, systolic, diastolic, MAP and pulse continuously every 2.5 minutes until the 30th minute. Then categorized into 3 groups based on BMI which is the Normal (BMI <24.9 kg/m2) Overweight (BMI 25 to 29.9 kg/m2) and Obese (BMI> 30 kg/m2). Results: The 38 samples that met criteria for inclusion in the Normal, Overweight and Obese consecutive experiencing hypotension 4/9 (44.4%), 14/17 (82.4%) and 11/12 (91.7% ) with p = 0.031 (p <0.05). While Relative Risk for overweight patients compared to normal was 1.85, being obese compared with normal was 2.06. Conclusion: Obtained the relationship between BMI and the incidence of hypotension in pregnant women who do sectio Caesarea using spinal block anesthesia in dr Soetomo’s hospital, Surabaya. The greater BMI the greater incidence of hypotension, Overweight subjects experienced hypotension incidence of 1.85 times greater than normal, while the Obese 2.06 times.
Keyword :
BMI, hypotension, spinal blocks, sectio Caesarea,
References :
A Fabbri,F Servadei, G Marchesini, S C Stein, A Vandelli,(2008) Early Predictors Of Unfavourable Outcome In Subjects With Moderate Head Injury In The Emergency Department New York : J Neurol Neurosurg Psychiatry
Andrew, robert B., Siva S., Melissa L,(2010) Augmented Creatinin Clearance in Traumatic Brain Injury London : Anesth Analg
Archive Article
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 Volume : 2 / No. : 1 / Pub. : 2013-12 |
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