Prevention of Spinal Anesthesia Induced Hypotension During Elective Cesarean Section

Keith Nelson


The incidence of cesarean delivery has increased dramatically over the past decade. According to the Center for Disease Control and Prevention's National Center for Health Statistics (NCHS), cesarean deliveries accounted for more than 30% of all births in 2005, setting a new United States record. Due to the increased risks, morbidity, and mortality associated with general anesthesia for cesarean sections, regional anesthesia is most often selected for non-emergent cesarean deliveries. Unless a preexisting labor epidural is in place, spinal anesthesia is most often the regional technique of choice for cesarean deliveries due to its immediate onset and dense blockade. Hypotension is a common occurrence following spinal anesthesia due to the blockage of sympathetic fibers in the spinal column. The incidence of hypotension varies widely in the literature, but is generally considered to be around 25-75%. Untreated severe hypotension can have detrimental effects on both mother and baby such as maternal nausea and vomiting or fetal distress. Despite years of research, there does not seem to be one established technique that is highly effective at preventing hypotension associated with spinal anesthesia

Consequently, an extensive literature review was done focusing on the various techniques utilized to prevent hypotension associated with spinal anesthesia during cesarean deliveries. The current techniques were divided into four main categories: administration of fluids, pharmacological, physical methods, and other interventions to include combination therapy. Data from the literature review was compiled, organized, and analyzed for credibility, reliability, and rigor

The goal of this project was to analyze the most current evidence-based practice techniques in the literature and disseminate the information via a presentation to 1st year Nurse Anesthesia students. The objective of the presentation was to increase their knowledge of the most current and efficacious techniques for preventing spinal anesthesia induced hypotension during elective cesarean section