Related Experiment Video
Updated: May 9, 2026
03:14
Spinal Sonography for Ultrasound-Guided Lumbar Neuraxial Anesthesia
Published on: January 31, 2025
Focused review: spinal anesthesia in severe preeclampsia
Vanessa G Henke1, Brian T Bateman, Lisa R Leffert
1From the Department of Anesthesia, Stanford University School of Medicine, Stanford, California; and Department of Anesthesia, Critical Care and Pain Medicine, Massachusetts General Hospital, Harvard Medical School, Boston, Massachusetts.
Anesthesia and Analgesia
|July 23, 2013
Summary
Spinal anesthesia is a safe choice for cesarean delivery in severe preeclampsia, with manageable hypotension risks. This review covers its benefits, drawbacks, and hemodynamic management strategies for this patient group.
Area of Science:
- Anesthesiology
- Obstetrics
- Critical Care Medicine
Background:
- Severe preeclampsia presents unique challenges for anesthesia during cesarean delivery.
- Neuraxial anesthesia is preferred, but concerns exist regarding spinal anesthesia's effects in this population.
Purpose of the Study:
- To review the advantages and limitations of spinal anesthesia for cesarean delivery in patients with severe preeclampsia.
- To discuss evidence-based intraoperative hemodynamic management strategies.
Main Methods:
- Literature review of studies on spinal anesthesia in severe preeclampsia.
- Analysis of hemodynamic responses and outcomes.
Main Results:
- Spinal anesthesia is a viable option for cesarean delivery in severe preeclampsia.
- Hypotension from spinal anesthesia is less frequent and severe than in healthy parturients.
- While potentially more frequent than epidural anesthesia, spinal-induced hypotension is transient and easily managed without adverse clinical outcomes.
Conclusions:
- Spinal anesthesia offers benefits for cesarean delivery in severe preeclampsia.
- Careful hemodynamic monitoring and management are crucial.
- Evidence supports its use when contraindications are absent.
Related Concept Videos
01:29Local Anesthetics: Clinical Application as Epidural Anesthesia
Epidural anesthetics are administered in the fat-filled epidural space, the outermost part of the spinal canal. This technique is commonly employed for pain management and anesthesia during lower abdomen and pelvis surgeries or labor and delivery.
Since epidural anesthetics can be infused through an epidural catheter, all types of drugs, including short-acting ones, can be administered. Chloroprocaine and lidocaine are examples of short and long-duration anesthetics, respectively. Bupivacaine...
Since epidural anesthetics can be infused through an epidural catheter, all types of drugs, including short-acting ones, can be administered. Chloroprocaine and lidocaine are examples of short and long-duration anesthetics, respectively. Bupivacaine...
01:11Local Anesthetics: Clinical Application as Spinal Anesthesia
Spinal anesthetics are given during lower abdomen and limb surgeries to block sensory and motor neurons. They are administered in the mid to low lumbar regions, primarily acting on the cauda equina's nerve roots. The blockade level depends on the local anesthetic (LA) concentration. Usually, low LA concentrations are sufficient to block sensory fibers, while only high LA concentrations block motor fibers. Other factors like injection volume and speed, the patient's posture, and the drug...
01:24General Anesthesia: Overview
Anesthesia is a medical procedure that uses drugs for CNS suppression to enable painless surgeries and procedures. The selection of anesthetics is influenced by their pharmacokinetic properties, side effects, and patient characteristics. Various types of anesthesia include general, local, regional, spinal, and inhalational.
General anesthesia induces unconsciousness in the whole body, while the others target specific areas or sensations. It is administered to minimize adverse effects, maintain...
General anesthesia induces unconsciousness in the whole body, while the others target specific areas or sensations. It is administered to minimize adverse effects, maintain...
01:22Aneurysm IV: Nursing Management
Vigilant monitoring for aneurysm rupture is essential for patients undergoing aortic surgery.Preoperative Nursing ManagementContinuously monitor the patient for manifestations of aneurysm rupture, such as pallor, weakness, tachycardia, hypotension, abdominal, back, groin, or periumbilical pain, changes in consciousness, and a pulsating abdominal mass. Regularly assess the patient's peripheral pulses.Instruct the patient to consume a clear liquid diet the day before surgery and administer...
01:24Parenteral Anesthetics: Overview
Intravenous anesthetics are drugs administered parenterally to induce anesthesia or sedation. Propofol is a widely used agent formulated as a 1% emulsion in soybean oil, glycerol, and egg phosphatide. It induces rapid anesthesia primarily due to its rapid distribution from the bloodstream to target tissues and is metabolized in the liver. However, it can cause significant pain on injection and hypertriglyceridemia. Fospropofol, a water-based prodrug of propofol, lacks these adverse effects.
01:16Local Anesthetics: Clinical Application as Intravenous Regional Anesthesia
Intravenous regional anesthesia or the Bier block technique is used to anesthetize a specific limb or extremity. It uses exsanguinated or blood-drained vessels to transport local anesthetics or LAs to the peripheral nerve trunks. Lidocaine without vasoconstrictors like epinephrine is most commonly used for this technique. Other drugs used are prilocaine, ropivacaine, and chloroprocaine. Bupivacaine is not recommended for this technique due to its high cardiac toxicity.
One of the advantages of...
One of the advantages of...