Abstract
Intravenous preloading was originally introduced to try to prevent or reduce hypotension caused by spinal anaesthesia for caesarean section.1 Following this, it became widely accepted that the same practice was appropriate for management of epidurals used for pain relief in labour. This occurred although such epidurals were given in smaller doses than those for caesarean section even before the introduction of low-dose epidural and combined spinal-epidural (CSE) techniques used on modern labour wards.
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References
Wollman SB, Marx GF. Acute hydration for the prevention of hypotension of spinal anesthesia in parturients. Anesthesiology 1968; 29: 374–80
Hahn RG, Drobin D, Stahle L. Volume kinetics of Ringer’s solution in female volunteers. Anaesthesia 1997; 78: 144–8
Cochrane Injuries Group Albumin Reviewers. Human albumin administration in critically ill atients: systematic review of randomised controlled trials. BMJ 1998; 317: 235–40
Collins KM, Bevan DR, Beard DW. Fluid loading to reduce abnormalities of fetal heart rate and maternal hypotension during epidural analgesia in labour. BMJ 1978; ii: 1460–1
Spencer TAD, Koutsoukis M, Lee A. Fetal heart rate and neonatal condition related to epidural analgesia in women reaching the second stage of labour. Europ J Obstet Gynecol Reprod Biol 1991; 41: 173–8
Steiger RM, Nageotte MP. Effect of uterine contractility and maternal hypotension on prolonged decelerations after bupivacaine epidural analgesia. Am J Obstet Gynecol 1990; 163: 808–12
Clarke VT, Smiley RM, Finster M. Uterine hyperactivity after intrathecal injection of fentanyl for analgesia during labor: a cause for fetal bradycardia? Anesthesiology 1994; 81: 1083
Friedlander JD, Fox HE, Cain CF. Fetal bradycardia and uterine hyperactivity following subarachnoid administration of fentanyl during labor. Reg Anesth 1997; 22: 378–81
Thimmons J, Laifer S, Ramanathan S. Subarachnoid fentanyl analgesia and uterine activity. Anesthesiology 1995; 83: A990
Thimmons J, Laifer S, Ramanathan S. Intravenous fluid bolus modifies the effects of intrathecal fentanyl on uterine activity. Abstract presented at Society of Obstetric Anesthesiology & Perinatology Annual Meeting, Tuscon 1996
Cheek TG, Samuels P Miller F, Tobin M, Gutsche BB. Normal saline iv fluid load decreases uterine activity in active labour. Br J Anaesth 1996; 77: 632–5
Milaszkiewicz RM, Smith D, Carli F, Gordon H. Is fluid pre-loading before epidural analgesia in labour always necessary? J Obstet Gynaecol 1991; 11: 110–1
Hammond RR, Webster AC. Haemodynamic effects of induction of epidural analgesia in labour. Can J Anaesth 1988; 35: 41–6
Patton DE, Lee W, Miller J, Jones M. Maternal, uteroplacental and fetoplacental hemodynamic and Doppler velocimetric changes during epidural analgesia in normal labor. Obstet Gynecol 1991; 77: 17–19
Timko Shannon M, Crivelli K, Ramanathan S. Is intravenous fluid bolus necessary before subarachnoid fentanyl administration for labor analgesia? Anesthesiology 1995; 83: A941
Slaymaker A, Bamber J, Hawthorne L, Dresner M. Is a fluid preload necessary with low-dose epidural analgesia in labour? (Abstract) International Journal of Obstetric Anesthesia 1998; 7: 197–198.
Zamora JE, Rosaeg OP, Lindsay MP, Crossan ML. Haemodynamic consequences and uterine contractions following 0.5 or 1.0 litre crystalloid infusions before obstetric epidural analgesia. Can J Anaesth 1996; 43: 347–52
Jackson R, Reid JA, Thorburn J. Volume preloading is not essential to prevent spinal-induced hypotension at caesarean section. B J Anaesth 1995; 75: 262–5
Husaini SW, Russell IF. Volume preload: lack of effect in the prevention of spinal-induced hypotension at caesarean section. International Journal of Obstetric Anesthesia 1998; 7: 76–81
Why mothers die; report on confidential enquiries into maternal deaths in the United Kingdom 1994–1996. HMSO, 1998
Ramsay IN, Torbet TE. Incidence of abnormal voiding parameters in the immediate postpartum period. Neurology and Urodynamics 1993; 12: 179–83
Hinman F. Postoperative overdistension of the bladder. Surg Gynecol Obstet 1976; 142: 901–2
Tarno-Mordi WO, Shaw JCL, Lin D, Gardner DA, Flynn FV. Iatrogenic hyponatraemia of the newborn due to maternal fluid overload: a prospective study. BMJ 1981; 283: 639–642
Feeney JG. Water intoxication and oxytocin. BMJ 1982; 284: 243
Ames A, Cobbold S, Maddock J. Lactic acidosis complicating treatment of ketosis in labour. BMJ 1975; 4: 611–613
Kenepp NB, Shelley WC, Gabbe SG, Kumar S, Stanley CA, Gutsche RB. Fetal and neonatal hazards of maternal hydration with 5% dextrose before caesarean section. Lancet 1982; 1: 1150–1152
Lawrence GF, Brown VA, Parsons RJ, Cooke ID. Feto-maternal consequences of high-dose glucose infusion during labour. Br J Obstet Gynaecol 1982; 89: 27–32
Report on confidential enquiries into maternal deaths in the United Kingdom 1991–1993. HMSO, 1996
Department of Health. Changing Childbirth. London: HMSO; 1993
Albright GA. Cardiac arrest following regional anesthesia with etidocaine or bupivacaine. Anesthesiology 1979; 51: 285–7
Kenepp NB, Gutsche BB. Inadvertant intravascular injections during lumbar epidural analgesia. Anesthesiology 1981; 54: 172–3
Norris MC, Fogel ST, Dalman H, Borrenpohl S, Hoppe W, Riley A. Labor epidural analgesia without an intravascular “test dose”. Anesthesiology 1998; 88: 1495–501
Beck H, Brassow F, Doehn M, Bause H. Epidural catheters of the multi-orifice type: dangers and complications. Acta Anaesthesiol Scand 1986; 30: 549–55
Moore DC, Batra MS. The components of an effective test dose prior to epidural block. Anesthesiology 1981; 55: 693–6
Leighton BL, Norris MC, DeSimone CA, Epstein R. The epinephrine test dose revisited, again. Anesthesiology 1988; 68: 807
Hood DID, Dewan DM, James FM. Maternal and fetal effects of epinephrine in gravid ewes. Anesthesiology 1986; 64: 610–13
Chestnut DH, Weiner CP, Herrig JE, Wang J. Effect of intravenous epinephrine upon uterine blood flow velocity in the pregnant guinea pig. Anesthesiology 1986; 65: 633–36
Cartwright PD, McCarroll SM, Antzaka C. Maternal heart rate changes with a plain epidural test dose. Anesthesiology 1986; 65: 226–8
Leighton BL, Norris MC, Sosis M, Epstein R, Chayen B, Larijani GE. Limitations of epinephrine as a marker of intravascular injection in laboring women. Anesthesiology 1987; 66: 688–91
Norris MC, Ferrenbach D, Dalman H, Fogel ST, Borrenpohl S, Hoppe W, Riley A. Does epinephrine improve the diagnostic accuracy of aspiration during labor epidural analgesia? Anesth Analg 1999; 88: 1073–6
Leighton BL, DeSimone C, Norris MC, Chayen B. Isoproterenol is an effective marker of intravenous injection in laboring women. Anesthesiology 1989; 71: 206–9
Cherala SR, Greene RG. Ephedrine as a marker of intravascular injection in laboring parturients. Reg Anesth 1990; 15: 15–18
Rottman RL, Miller M, Yoshii WY, Kotelko DM, Wright WC, Stone JJ, Rasmus KT. Fentanyl as an epidural intravascular test dose in obstetrics. Anesth Analg 1990; 70: S336
Leighton BL, Gross JB. Air: an effective indicator of intravenously located epidural catheters. Anesthesiology 1989; 71: 848–51
el-Behesy BA, James D, Koh KF, Hirsch N. Distinguishing cerebrospinal fluid from saline used to identify the epidural space. Br J Anaesth 1996; 77: 784–5
Richardson MG, Lee AC, Wissler RN. High spinal anesthesia after epidural test dose in five obstetric patients. Reg Anesth 1996; 21: 119–23
Richardson MG, Wissler RN. Unexpected high spinal block in obstetrics. Br J Anaesth 1996: 77: 806
Palkar NV, Boudreaux RC, Mankad AV. Accidental total spinal block: a complication of an epidural test dose. Can J Anaesth 1992; 39: 1058–60
Evans TI. Total spinal anaesthesia. Anaesth Intensive Care 1974; 2: 158–63
Fine PG, Wong KC. Cranial nerve block after test dose through an epidural catheter in a preeclamptic. Can Anaesth Soc J 1984; 31: 565–7
Stonham J, Moss P. The optimal test dose for dose for epidural anesthesia. Anesthesiology 1983; 58: 389–90
Russell IF. Inadvertent total spinal for caesarean section. Anaesthesia 1985; 40: 199–200
Vucevic M, Russell IF. Spinal anaesthesia for caesarean section: 0.125% plain bupivacaine 12 ml compared with 0.5% plain bupivacaine 3 ml. Br J Anaesth 1992; 68: 590–5
Van Zundert AA, De Wolf AM, Vaes L, Soetens M. High volume spinal anesthesia with bupivacaine 0.125% for cesarean section. Anesthesiology 1988; 69: 998–1003
Cox M, Lawton G, Gowrie-Mohan S, Morgan B. Let us re-examine the safety of midwife epidural top ups. Anaesthesia 1995; 50: 750–1
Reynolds F, Speedy HM. The subdural space: the third place to go astray. Anaesthesia 1990; 45: 120–3
Russell R. Practical Procedures. In: Reynolds F ed. Pain Relief in Labour.London: BMJ Publishing Group, 1997: 193–4
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Scrutton, M., Kinsella, S.M. (2000). Before the block: fluid preloading and testing the catheter. In: Reynolds, F. (eds) Regional Analgesia in Obstetrics. Springer, London. https://doi.org/10.1007/978-1-4471-0435-3_13
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DOI: https://doi.org/10.1007/978-1-4471-0435-3_13
Publisher Name: Springer, London
Print ISBN: 978-1-4471-1142-9
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