Advances in understanding and management in obstetric anaest

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Advances in understanding and management in obstetric anaesthesia': The great myth of our times

May 31, 2017551 views

Even after more than one century of Kreis' demonstration of spinal anaesthesia in obstetrics, understanding the complexity of the anatomy, physiology, pharmacology and application of neuraxial anaesthesia (NA) is still debatable. The reported incidence of hypotension and bradycardia after NA is 33% in the obstetric and 13% in the non-obstetric population. According to traditional teaching, this hypotension is a consequence of a decrease in venous return (VR) and cardiac output (CO) (pre-load reduction theory), caused by the NA-induced preganglionic sympathetic nerve blockade and supine hypotension syndrome of pregnancy (SHSP)...

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