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February 24, 1962

Spinal Anesthesia for Cesarean Section: Clinical and Biochemical Studies of Effects on Maternal Physiology

Author Affiliations

New York City

From the departments of anesthesiology and obstetrics, Columbia University, College of Physicians and Surgeons, and the Anesthesiology Service, Presbyterian Hospital and the Sloane Hospital for Women.; Assistant Professor, Department of Anesthesiology, Columbia University (Dr. Moya); and Lieutenant, Medical Corps, United States Navy, United States Naval Hospital, Portsmouth, Va. (Dr. Smith).; Read before the Section on Anesthesiology at the 110th Annual Meeting of the American Medical Association, New York City, June 28, 1961.

JAMA. 1962;179(8):609-614. doi:10.1001/jama.1962.03050080021005

Of a series of 1,141 patients who received ephedrine prophylactically, 46% had prepartum falls in blood pressure exceeding 20% of the preanesthetic level, and in more than half of the women the systolic pressure fell below 100 mm. Hg. No correlation was found between the incidence of hypotension and the level of sensory analgesia. In a comparable group of 64 patients methoxamine hydrochloride was found to be more effective as a prophylactic and therapeutic agent than ephedrine. However, there was also a significantly greater incidence of hypertension with methoxamine. It was found that spinal anesthesia did not impair the effectiveness of ventilation as measured by arterial blood pCO2 provided small doses of the agent were used and blood pressure was maintained.