Anesthesia, Obstetrical Clinical Trial
Official title:
The Effect of Body Mass Index, Intra-abdominal Pressure, Abdominal Girth and Waist Circumference on Sensory Block Level After Single-shot Spinal Anesthesia for Cesarean Section
Although the exact mechanism remains unknown, the association of pregnancy and decreased local anesthetic requirement is clear. demonstrated that more local anesthetic is required for cesarean section under combined spinal-epidural anesthesia in preterm compared with term patients.
However, in pregnant patients, venous engorgement is prominent in the supine but not the
lateral position, which suggests direct compression of the inferior vena cava by the gravid
uterus. Second, an increase in intraabdominal pressure may affect the retroperitoneal area
and may cause inward movement of soft tissue in the intervertebral foramina. Recent magnetic
resonance imaging studies in pregnant patients, although without intraabdominal pressure
measurements, suggested the latter because they showed limited contact of engorged veins
along the dural sac which may therefore not be responsible for compression of the dura.
If elevated intraabdominal pressure contributes to high anesthetic spread during pregnancy,
one would expect a relationship between intraabdominal pressure and maximum sensory block
level.
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