In Practice

Recipes for obstetric spinal hypotension: The clinical context counts

David G Bishop, Reitze N Rodseth, Robert A Dyer

Abstract


Hypotension following obstetric spinal anaesthesia remains a common and important problem. While recent research advances have brought us closer to the perfect recipe for the obstetric spinal anaesthetic, these advances have not been translated into practical guidelines able to reduce the unacceptable number of fatalities that occur in environments where resources are limited. In South Africa, more than half of anaesthetic deaths are still related to spinal hypotension. A gap exists between the ‘perfect recipe’, developed from a clinical context rooted in resource-rich research environments, and its application and performance in real-world resource-poor environments – conditions experienced by more than 75% of the world’s population. This review attempts to define this knowledge gap and proposes a research agenda to address the deficiencies.


Authors' affiliations

David G Bishop, Perioperative Research Group, Department of Anaesthetics, Edendale Hospital, Pietermaritzburg, South Africa, and School of Clinical Medicine, College of Health Sciences, Nelson R Mandela School of Medicine, University of KwaZulu-Natal, South Africa

Reitze N Rodseth, Perioperative Research Group, Department of Anaesthetics, Grey’s Hospital, Pietermaritzburg, South Africa, and School of Clinical Medicine, College of Health Sciences, Nelson R Mandela School of Medicine, University of KwaZulu-Natal, South Africa; Department of Outcomes Research, Cleveland Clinic, Cleveland, Ohio, USA

Robert A Dyer, Department of Anaesthesia and Perioperative Medicine, Faculty of Health Sciences, University of Cape Town, South Africa

Full Text

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Keywords

Obstetrics; Spinal; Anaesthesia; Hypotension

Cite this article

South African Medical Journal 2016;106(9):861-864. DOI:10.7196/SAMJ.2016.v106i9.10877

Article History

Date submitted: 2016-04-07
Date published: 2016-08-01

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