Haemodynamic effects of the position chosen for the insertion of an epidural catheter.

Abstract:

:An epidural catheter may be inserted with the patient either in the flexed left lateral or the sitting position. We have studied, non-invasively, the haemodynamic changes associated with these positions, using the thoracic bio-impedance method (BOMED NCCOM3 Monitor). Maternal arterial pressure and fetal heart rate were monitored simultaneously. Twenty healthy pregnant patients at term and 20 non-pregnant healthy controls, matched for age and height, were studied. The pregnant patients were scheduled for elective caesarean section and had singleton healthy fetuses. A significant reduction in stroke index (SI) occurred when the pregnant patients were repositioned from supine 15degrees wedged position to either flexed left lateral (P < 0.01) or sitting positions (P < 0.05). Similar reductions in SI with positioning were observed in the non-pregnant patients: flexed left lateral (P < 0.01); and sitting (P < 0.01). These changes in SI produced significant reductions in cardiac index (CI) in both groups. In the pregnant patients the CI was significantly lower in the flexed left lateral than in the sitting position (P < 0.01). Consequently maternal systolic blood pressure was lower in the flexed left lateral position (P < 0.01).

journal_name

Int J Obstet Anesth

authors

Chadwick IS,Eddleston JM,Chandelier CK,Pollard BJ

doi

10.1016/0959-289x(93)90046-k

subject

Has Abstract

pub_date

1993-01-01 00:00:00

pages

197-201

issue

4

eissn

0959-289X

issn

1532-3374

pii

0959289X9390046K

journal_volume

2

pub_type

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