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KMID : 0356919950280060821
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Korean Journal of Anesthesiology
1995 Volume.28 No. 6 p.821 ~ p.827
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The Need of Central Venous Pressure Monitoring in Patients with Severe Preeclampsia before Epidural Anesthesia
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Abstract
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Most obstetric anesthesiologist now consider epidural anesthesia to be the preferred anesthetic technique for patients with preeclampsia. In the severe preeclampsia effective circulatory volume is usually low, so appropriate preanesthetic
hydration
is
essential feature of safe management.
We performed CVP monitoring before epidural anesthesia in nine severe preeclamptic patients undergoing cesarean section. Mean CVP of them was 2(1 mm Hg which was not significantly different from normal term parturient. In four patients whose CVP
was
less than 2 mmHg, preanesthetic hydration with Hartman's solution 500~700 ml was performed under the monitoring of CVP until it became to rise 2~3 mmHg, five patients out of nine whose systolic blood pressure dropped below 100 mmHg during
anesthesia
were IV injected ephedrine 4 mg immediately and three of them needed repeat injection of ephedrine 4 mg.
With the monitoring of CVP, the operations of all the nine severe preeclamptic patients were completed successfully without any problem during and after anesthesia.
It is important to realize the limitation of central venous pressure monitoring; but if used with caution in proper circumstance it can provide clinically useful information with minimal risk to the patient.
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KEYWORD
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