الفهرس 
INTRODUCTIONOnly 14 pages are availabe for public view
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Abstract
The spinal anesthetic block is an excellent choice for cesarean delivery because of its rapid onset and dense sensory block. However, hypotension that ensues immediately after placement is common and can negatively impact the mother and fetus if left untreated. There are various mechanisms that contribute to hypotension in the parturient, but arterial dilatation appears to be the major factor leading to hypotension. Therefore, vasopressors are the mainstay for managing spinal-induced hypotension, whereas fluid- loading strategies, left uterine displacement, and mechanical lower extremity compression have limited effectiveness. In non-elective cesarean deliveries, the use of phenylephrine is associated with improved no hypotensive attacks, reduced risk of maternal nausea and vomiting compared with the use of norepinephrine but less favorable neonatal acid-base status. Prophylactic phenylephrine infusion can maintain stable blood pressure and effectively eliminate hypotension when used at fixed dose regemin. Hypotension commonly occurs in parturients undergoing cesarean delivery under spinal anesthesia. This leads to maternal and neonatal adverse outcomes, including maternal nausea and vomiting and fetal acidosis, and might even lead to cardiovascular collapse if not treated. Arterial dilatation and reduction in systemic vascular resistance are the major contributors to spinal-induced hypotension.[10] Therefore, strategies aimed at expanding the intravascular volume with fluid loading or increasing venous return with lower extremities mechanical compression and lateral tilt have had limited effectiveness in the management of spinal-induced hypotension