Prevention and treatment of maternal hypotension under combined spinal and epidural anesthesia for caesarean section

Abstract

Background Maternal hypotension is a common complication of combined spinal and epidural anesthesia(CSEA) during caesarean delivery, which is associated with adverse effects on both the mother and the fetus when appropriate treatments were not used. Objective To review the effects of different methods for preventing and treating maternal hypotension, improving the circulation and internal environment of maternal and fetus according to the mechanism of hypotension, and to provide a reference for clinical anesthesia. Content Hypotension could be relieved by the following treatments: fluid preloading, maternal position, anesthesia plane, local anesthetic, the 5-hydroxytryptamine 3(5-HT3) receptor antagonist, anticholinergic drugs or vasopressors although their effects are different. Therefore, combination of these treatments can get better effects. Trend Predicting the incidence and severity of hypotension according to maternal different conditions may help choose the targeted strategies, while more relevant researches should be carried out. Key words: Combined spinal and epidural anesthesia; Hypotension; Cesarean section