Der Anaesthesist
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Arterial hypotension is a frequent complication following spinal anesthesia for cesarean sections. A fast treatment is necessary to maintain the well-being of the mother and to avoid deficiencies in the intrauterine supply to the child. ⋯ The differences of the individual vasoactive substances seemed to be much smaller than one would expect based on the results of randomized clinical trials. The incidence and extent of bradycardia and neonatal acidosis were much lower than previously reported. The determined differences seemed to have no major clinical relevance. Although the A group required less bolus administrations and seemed to be the most potent substance, the results imply that the assessment of the effects of vasoactive substances should not be carried out without consideration of the accompanying measures.
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Adults with congenital heart disease (CHD) represent an increasing proportion of patients undergoing non-cardiac surgery. ⋯ Decisive for the perioperative outcome of patients with CHD are the identification of high-risk patients, understanding of the individual situation with respect to the underlying pathophysiology and the intraoperative maintenance of cardiac output.