الفهرس 
ANATOMYOnly 14 pages are availabe for public view
 |  | from | 128 |  |  |
| | | from | 128 | | |
Abstract
A
nesthesiologists prefer the technique of spinal anesthesia in elective cesarean section for its rapid onset, fewer risk of local anesthetic toxicity, minimal transfer of the drugs to fetus and dense neural block. While general anesthesia is preferred when there is an absolute contraindication for regional anesthesia or in cases of emergency which will need rapid sequence induction.
Maternal hypotension following spinal anesthesia is one of the leading complications and most anticipating one. Maternal hypotension is defined as decrease in systolic blood pressure by a 20% from baseline which may cause a series of event during cesarean section. So, it is important to be treated if happened and prevent it in order to preserve normal maternal blood pressure and adequate blood supply to uterus, placenta and fetus.
To overcome the problem of maternal hypotension induced by regional anesthesia especially subarachnoid anesthesia there are many measures to be taken in consideration avoidance of aortocaval compression, intravenous administration of crystalloids also, frequent monitoring of arterial blood pressure after placing of regional anesthesia all are measures.
Vasopressor administration is one of customary way in treating of hypotension and one of the vasopressors showed a good response in dealing with hypotension event that follows sub arachnoid anesthesia is Norepinephrine.
The aim of this study to assess the effectiveness of minimal dose of norepinephrine in preventing the episodes of hypotension that follow subarachnoid anesthesia in elective cesarean section.
The study was conducted on 60 randomly chosen patients full filling the inclusion criteria at Ain-Shams university hospitals after approval of medical committee. They were allocated in two groups of 30 patients each:
group (A) received the minimal dose of norepinephrine (25-30 nanogram/kg/min).
group (B) didn’t receive an infusion with vasopressor.
The two groups were adequately assessed pre-operative and monitored intra- and post operatively and they were compared in vital data as regarding SBP, DBP, MAP, HR, other Maternal data and also Neonatal data.
The results of the study showed that patients in the study group (A) had less events of hypotension 10% (3 patients need treatment dose of ephedrine) compared to 76% (23 patients need treatment dose of ephedrine) in group (B) and less Tachycardia in group (A) with only 3.3% compared to group (B) which were 70%. Although no statistical difference in all other parameters measured in this study.
CONCLUSION
• Our study suggests that the use of norepinephrine as a vasopressor in the treatment of subarachnoid induced hypotension is safe and effective.
• The use of norepinephrine in this study prevent and to moderate minimize the events of hypotension and the need of overriding dose of ephedrine to treat hypotension, and maintain the normal heart rate.
• The use of norepinephrine shows no changes in the maternal parameters measured such as maternal PH, Serum lactate level and maternal urine output also this present in the results from other group.
• Neonatal APGAR score at 1st and 5th minutes shows no change together with neonatal blood gases in either groups.