International Journal of Obstetric Anesthesia
Volume 19, Issue 3 , Pages 282-286 , July 2010

An observational study of skin conductance monitoring as a means of predicting hypotension from spinal anaesthesia for caesarean delivery

  • T. Ledowski

      Affiliations

    • School of Medicine and Pharmacology, University of Western Australia, Australia
    • ,
  • M.J. Paech

      Affiliations

    • School of Medicine and Pharmacology, University of Western Australia, Australia
    • Corresponding Author InformationCorrespondence to: Michael Paech, Department of Anaesthesia and Pain Medicine, King Edward Memorial Hospital for Women, 374 Bagot Rd, Subiaco, 6008 Western Australia, Australia. Tel.: +61 8 93402250; fax: +61 8 93402260.
    • ,
  • R. Browning

      Affiliations

    • Department of Anaesthesia and Pain Medicine, King Edward Memorial Hospital for Women, Western Australia, Australia
    • ,
  • J. Preuss

      Affiliations

    • School of Medicine and Pharmacology, University of Western Australia, Australia
    • ,
  • S.A. Schug

      Affiliations

    • School of Medicine and Pharmacology, University of Western Australia, Australia

,Accepted 21 January 2010.

References 

  1. Cyna AM, Andrew M, Emmett RS, Middleton P, Simmons SW. Techniques for preventing hypotension during spinal anaesthesia for caesarean section. Cochrane Database of Systematic Reviews 2006, Issue 4. Art. No.: CD002251. DOI: 10.1002/14651858.CD002251.pub2.
  2. Ouzounian JG, Masaki DI, Abboud TK, Greenspoon JS. Systemic vascular resistance index determined by thoracic electrical bioimpedance predicts the risk for maternal hypotension during regional anesthesia for cesarean delivery. Am J Obstet Gynecol. 1996;174:1019–1025
  3. Garrison R, Wiley J, Philip S, Sharma S. Prevention of hypotension following spinal anesthesia for cesarean section using noninvasive transthoracic electrical impedance cardiography (abstract). Anesthesiology. 2005;102(Suppl. 1):SOAP A-3
  4. Frohlich MA, Caton D. Baseline heart rate may predict hypotension after spinal anesthesia in prehydrated obstetrical patients. Can J Anesth. 2002;49:185–189
  5. Chamchad D, Arkoosh VA, Horrow JC, et al. Using heart rate variability to stratify risk of obstetric patients undergoing spinal anesthesia. Anesth Analg. 2004;99:1818–1821
  6. Hanss R, Bein B, Ledowski T, et al. Heart rate variability predicts severe hypotension after spinal anesthesia for elective cesarean delivery. Anesthesiology. 2005;102:1086–1093
  7. Hanss R, Bein B, Francksen H, et al. Heart rate variability-guided prophylactic treatment of severe hypotension after subarachnoid block for elective caesarean delivery. Anesthesiology. 2006;104:635–643
  8. Fujiwara Y, Sato Y, Shibata Y, Asakura Y, Nishiwaki K, Komatsu T. A greater decrease in blood pressure after spinal anaesthesia in patients with low entropy of the RR interval. Acta Anaesthesiol Scand. 2007;51:1161–1165
  9. Storm H. Changes in skin conductance as a tool to monitor nociceptive stimulation and pain. Curr Opin Anaesthesiol. 2008;21:796–804
  10. Ledowski T, Preuss J, Kapila R, Ford A. Skin conductance as a means to predict hypotension following spinal anaesthesia. Acta Anaesthesiol Scand. 2008;52:1342–1347
  11. Moerman N, van Dam FSAM, Muller MJ, Oosting H. The Amsterdam preoperative anxiety and information scale (APAIS). Anesth Analg. 1996;82:445–451
  12. Ngan Kee WD, Khaw KS, Ng FF. Comparison of phenylephrine infusion regimens for maintaining maternal blood pressure during spinal anaesthesia for Caesarean section. Br J Anaesth. 2004;92:469–474
  13. Ebner H, Barcohanan J, Bartoshok AK. Influence of post-spinal hypotension on the fetal electrocardiogram. Am J Obstet Gynecol. 1960;80:569–572
  14. Ledowski T, Bromilow J, Paech MJ, Storm H, Hacking R, Schug SA. Skin conductance monitoring compared with Bispectral Index monitoring to assess emergence from general anaesthesia using sevoflurane and remifentanil. Br J Anaesth. 2006;97:187–191
  15. Ledowski T, Bromilow J, Wu J, Paech MJ, Storm H, Schug SA. The assessment of postoperative pain by monitoring of skin conductance. Results of a prospective study. Anaesthesia. 2007;62:989–993
  16. Kinsella SM, Norris MC. Advance prediction of hypotension at cesarean delivery under spinal anesthesia. Int J Obstet Anesth. 1996;5:3–7
  17. Dahlgren G, Granath F, Wessel H, Irestedt L. Prediction of hypotension during spinal anesthesia for cesarean section and its relation to the effect of crystalloid or colloid preload. Int J Obstet Anesth. 2006;16:128–134
  18. Sharwood-Smith G, Bruce J, Drummond G. Assessment of pulse transit time to indicate cardiovascular changes during obstetric spinal anaesthesia. Br J Anaesth. 2006;96:100–105
  19. Kimura T, Kimatsu T, Hirabayashi A, Sakuma I, Shimada Y. Autonomic imbalance of the heart during total spinal anesthesia evaluated by spectral analysis of heart rate variability. Anesthesiology. 1994;80:694–698
  20. Smiley RM, Blouin J, Negron M, Freedman PV, Scott JA, Landau R. ASP298 polymorphism of endothelial nitric oxide synthase does not affect response to treatment of hypotension during spinal anesthesia for cesarean section (abstract). Anesthesiology. 2005;102(Suppl. 1):SOAP A-26
  21. Smiley RM, Blouin JL, Negron M, Landau R. Beta2-adrenoreceptor genotype affects vasopressor requirements during spinal anesthesia for cesarean delivery. Anesthesiology. 2006;104:644–650

PII: S0959-289X(10)00016-6

doi: 10.1016/j.ijoa.2010.01.001

International Journal of Obstetric Anesthesia
Volume 19, Issue 3 , Pages 282-286 , July 2010

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