Survey of Anesthesiologists’ Practices for Management of Spinal Anaesthesia-Induced Hypotension During Caesarean Section in Thailand
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Abstract
Background: The international consensus for management of spinal anaesthesia-induced hypotension (SAIH) during caesarean section advocates the prophylaxis with phenylephrine, colloid preloading or crystalloid coloading, and left uterine displacement (LUD), to maintain systolic arterial pressure (SAP) higher than 90% and avoid a decrease lower than 80% of baseline.
Objective: To explore Thai anesthesiologists’ practices for management of SAIH during caesarean section.
Methods: An online questionnaire survey was sent to 152 anesthesiologists during the period from September to October 2022. Data collection included personal information and the management of SAIH.
Results: Of 152 anesthesiologists, 90.1% were graduated anesthesiologists, 44.1% were between 10 to 19 years of work experience, and 36.2% were academic institution. Most of them (96.7%) used both prophylaxis and treatment for management of SAIH. For prophylaxis, 45.4% used 2 combined methods (intravenous fluid and LUD), 38.1% did not use vasopressors, 29.6% used ephedrine, and 9.2% used ephedrine and phenylephrine. For treatment, 51.3% used 3 combined methods (vasopressor, intravenous fluid, and LUD), 38.2% ephedrine and noradrenaline, and 19.7% used ephedrine and phenylephrine. Treatments for SAP below 100 mmHg and less than 80% of baseline were 36.8% and 31.5%, respectively. Only 49.3% had available phenylephrine in their hospitals.
Conclusions: This finding showed that methods and concepts for management of SAIH in Thailand were different from the international guideline. Available phenylephrine in all hospitals for prophylaxis and early treatment of decreased SAP should be promoted.
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References
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