Closed-loop double-vasopressor automated system to treat ... Email: [email protected] ... vasopressor, automated system that integrates beat-to-.
Anaesthesia 2012, 67, 1348–1355
doi:10.1111/anae.12000
Original Article Closed-loop double-vasopressor automated system to treat hypotension during spinal anaesthesia for caesarean section: a preliminary study A. T. H. Sia,1 H. S. Tan2 and B. L. Sng3 1 Chairman, Medical Board, 3 Consultant, Department of Women’s Anaesthesia, KK Women’s and Children’s Hospital, Singapore 2 Medical student, Duke-NUS Graduate Medical School, Singapore
Summary Hypotension occurs in most caesarean sections under spinal anaesthesia, necessitating vasopressor administration. However, the optimal dosing regimen remains unclear. We have developed a novel vasopressor delivery system that automatically administers phenylephrine or ephedrine based on continuous non-invasive blood pressure monitoring. This prospective cohort study recruited 55 healthy women under standardised spinal anaesthesia with 2.2 ml hyperbaric bupivacaine 0.5%, 15 lg fentanyl and 100 lg morphine. A 50-lg phenylephrine bolus was given at 1-min intervals when systolic blood pressure fell below 90% of baseline, and a 4-mg ephedrine bolus was given when hypotension developed with bradycardia (heart rate
