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Original Article

Effect of Injection Speed of Local Anesthetic on Hypotension during Spinal Anesthesia for Cesarean Section

Yong In Kang, Eun Chi Bang, Dong-Wook Shin, Dae Eun Kweon, Su Yeon Kim, Hyun Sook Lee, Kyung Sook Cho, Su Yeon Lee
The Ewha Medical Journal 2012;35(2):83-88. Published online: September 30, 2012

Department of Anesthesia and Pain Medicine, Gangnam Medical Center, CHA University, Seoul, Korea.

Corresponding author: Yong In Kang, Department of Anesthesia and Pain Medicine, Gangnam Medical Center, CHA University, 566 Nonhyeon-ro, Gangnam-gu, Seoul 135-913, Korea. Tel: 82-2-3468-3080, Fax: 82-2-558-1119, anein09@hanmail.net
• Received: June 5, 2012   • Accepted: July 2, 2012

Copyright © 2012. Ewha Womans University School of Medicine

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  • Objectives
    Maternal hypotension is a common problem during cesarean section under spinal anesthesia. We evaluated the influence of injection speed of local anesthetic to subarachnoid space on maternal hypotension and level of sensory block.
  • Methods
    Bupivacaine (0.5%) 9 mg with fentanyl 10 µg was injected to subarachnoid space either quickly (during 20 seconds, 0.1 mL/sec, n=20) or slowly (during 100 seconds, 0.02 mL/sec, n=20) in parturients scheduled for elective cesarean section. The onset and level of sensory block was checked and heart rate and blood pressure was checked by 2.5 minutes during 20 minutes. Hypotension (systolic blood pressure <100 mmHg or <70% of baseline) was treated with ephedrine.
  • Results
    Hypotension occurred 70% of parturients with spinal anesthesia. Slow injection didn't influence on the onset and level of sensory block and didn't reduce the incidence of hypotension. But onset of hypotension was delayed.
  • Conclusion
    Slow injection (during 100 seconds, 0.02 mL/sec) of local anesthetic delayed onset of hypotension and required less amount of ephedrine. Slow injection of local anesthetic was one of the effective methods for the cardiovascular stability during cesarean section under spinal anesthesia.
  • Keywords: Anesthesia; Cesarean section; Hypotension; Speed; Spinal injection
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  • 2. Simon L, Boulay G, Ziane AF, Noblesse E, Mathiot JL, Toubas MF, et al. Effect of injection rate on hypotension associated with spinal anesthesia for cesarean section. Int J Obstet Anesth 2000;9:10-14.
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Table 1
Patient characteristics

There are no significant differences between two groups. The values are presented as mean±SD.

emj-35-83-i001.jpg
Table 2
Data between two groups

There are no significant differences between two groups. Values are presented as mean±SD.

emj-35-83-i002.jpg
Table 3
Ephedrine data

There are significant difference between two groups in the first ephedrine injection time but no differences in the number of use and amount of ephedrine. Values are presented as mean±SD. *P<0.05 between two groups.

emj-35-83-i003.jpg
Table 4
Hemodynamic data in two groups

There are no significant differences between two groups in SBP, DBP and HR. Values are presented as mean±SD. SBP, systolic blood pressure; DBP, diastolic blood pressure; HR, heart rate.

emj-35-83-i004.jpg

Figure & Data

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      Effect of Injection Speed of Local Anesthetic on Hypotension during Spinal Anesthesia for Cesarean Section
      Ewha Med J. 2012;35(2):83-88.   Published online September 30, 2012
      DOI: https://doi.org/10.12771/emj.2012.35.2.83
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      • Citation for the content below
      Effect of Injection Speed of Local Anesthetic on Hypotension during Spinal Anesthesia for Cesarean Section
      Ewha Med J. 2012;35(2):83-88.   Published online September 30, 2012
      DOI: https://doi.org/10.12771/emj.2012.35.2.83
      Close
      Effect of Injection Speed of Local Anesthetic on Hypotension during Spinal Anesthesia for Cesarean Section
      Effect of Injection Speed of Local Anesthetic on Hypotension during Spinal Anesthesia for Cesarean Section

      Patient characteristics

      There are no significant differences between two groups. The values are presented as mean±SD.

      Data between two groups

      There are no significant differences between two groups. Values are presented as mean±SD.

      Ephedrine data

      There are significant difference between two groups in the first ephedrine injection time but no differences in the number of use and amount of ephedrine. Values are presented as mean±SD. *P<0.05 between two groups.

      Hemodynamic data in two groups

      There are no significant differences between two groups in SBP, DBP and HR. Values are presented as mean±SD. SBP, systolic blood pressure; DBP, diastolic blood pressure; HR, heart rate.
      Table 1 Patient characteristics

      There are no significant differences between two groups. The values are presented as mean±SD.

      Table 2 Data between two groups

      There are no significant differences between two groups. Values are presented as mean±SD.

      Table 3 Ephedrine data

      There are significant difference between two groups in the first ephedrine injection time but no differences in the number of use and amount of ephedrine. Values are presented as mean±SD. *P<0.05 between two groups.

      Table 4 Hemodynamic data in two groups

      There are no significant differences between two groups in SBP, DBP and HR. Values are presented as mean±SD. SBP, systolic blood pressure; DBP, diastolic blood pressure; HR, heart rate.

      Table 1

      Table 2

      Table 3

      Table 4

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