Spinal anesthesia in cesarean section

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Spinal anesthesia in C-sec1) Preparation
Positioning: lateral decubitus position
Monitoring: BP, PR, SpO2, FHR
Rapid injection of isotonic electrolyte solution
Oxygenation via mask or nasal tube
Check devices for CPR and medication
O2-supply system in anesthesia machine
Airway
Laryngoscope
Endotracheal tube
Thiopental or diazepam for seizure
Ephedrine or phenylephrine for hypotension
Suction devices

<중 략>

Check ABP: per 1 min. until fetal expulsion per 5 min.
When SBP 30 % ↓ or <90 mmHg
Left uterine displacement & rapid injecting fluid
If No effect ephedrine 15 mg IV or phenylephrine 50-100 μg IV(if necessary, repeat)
Analgesics
Morphine 3-5 mg IV or PCA IV
No effect G/A
For anxiety or incomplete anesthesia
Midazolam 0.25-1.0 mg IV
Fentanyl 0.5-1 μg/kg IV
40-50 % N2O
Ketamine 0.25 mg/kg IV
0.5 % lidocaine 10-20 ml IP

참고 자료

마취과학(Anesthesia and Pain Management), 대한 마취과학회, 2nd ed. 2010
Pregnancy and the orthopaedic patient, Niall P. Mcgoldrick et al., Orthopaedics and Trauma, Volume 26, Issue 3, June 2012, Pages 212-219