Data on central hemodynamics of pregnant women during regional anesthesia is lacking. The purpose of this study is to determine the 1) influence of heart rate (HR), stroke volume (SV), systemic vascular resistance (SVR) and IV fluid administration on maternal hypotension after epidural anesthesia and 2) the pattern of these variables throughout C-section. Despite preventative measures, hypotension during regional anesthesia for cesarean section is common. Maternal hypotension poses a risk to fetal oxygenation, causes maternal nausea and vomiting, and poses maternal danger when extreme. Intravenous fluid is most often used to prevent hypotension, but an optimal volume of fluid has not been found and the incidence of hypotension varies widely. Fluid alone at best reduces the incidence of hypotension at 38%. An underlying practice assumption is that regional anesthesia, which results in a chemical sympathectomy, causes hypotension by reducing venous return and does not significantly reduce widely. Fluid alone at best reduces the incidence of hypotension at 38%. An underlying practice assumption is that regional anesthesia, which results in a chemical sympathectomy, causes hypotension by reducing venous return and does not significantly reduce SVR. This view is based on an average 15% (range up to 40%) reduction in SVR in non-pregnant persons. But there is evidence that SVR is reduced more in pregnant than non-pregnant women during regional anesthesia. If SVR is reduced sufficiently, fluid alone will not increase cardiac output enough to prevent hypotension. In this case, addressing SVR should result in superior prevention of hypotension. Determining which variables have a significant influence on the pattern of hypotension over time is necessary to direct future interventional studies. Elimination of maternal hypotension will reduce the risk of fetal hypoxemia, maternal discomfort, and maternal morbidity while improving maternal enjoyment of the birth experience.

Agency
National Institute of Health (NIH)
Institute
National Institute of Nursing Research (NINR)
Type
Predoctoral Individual National Research Service Award (F31)
Project #
5F31NR007700-02
Application #
6539464
Study Section
National Institute of Nursing Research Initial Review Group (NRRC)
Program Officer
Bryan, Yvonne E
Project Start
2002-04-01
Project End
Budget Start
2002-04-01
Budget End
2002-09-30
Support Year
2
Fiscal Year
2002
Total Cost
$15,822
Indirect Cost
Name
University of Tennessee Health Science Center
Department
Other Health Professions
Type
Schools of Nursing
DUNS #
941884009
City
Memphis
State
TN
Country
United States
Zip Code
38163