Prevention and Treatment of Hypotension during Neuraxial Block

Abstract

Neuraxial block involves spinal anesthesia, epidural anesthesia and combined spinal epidural anesthesia. S.A is used widely for both lower limbs and lower abdominal surgeries. It gives good sensory and motor block, reduces incidence of D.V.T and pulmonary embolism, provides postoperative pain relief and early ambulation. Epidural anesthesia is used for upper abdominal and thoracic surgeries, also as a supplement to general anesthesia for providing excellent control of chronic pain. Neuraxial block is achieved by sympathetic block which lead to decrease venous return to the heart and decrease systemic vascular resistance after blockade of preganglionic sympathetic fibers that causes hypotension. Hypotension is defined as systolic blood pressure less than 90 mmHg or decrease from baseline more than 30%. Preoperative hypotension should be corrected to reduce morbidity and mortality.