Closed-loop feedback computer-controlled infusion of phenylephrine for maintaining blood pressure during spinal anaesthesia for caesarean section: a preliminary descriptive study

Anaesthesia. 2007 Dec;62(12):1251-6. doi: 10.1111/j.1365-2044.2007.05257.x.

Abstract

We describe the novel use of a closed-loop feedback computer-controlled infusion of phenylephrine for maintaining blood pressure in 53 patients having spinal anaesthesia for elective caesarean section. A simple on-off algorithm was used that activated an intravenous phenylephrine infusion at 100 microg.min(-1) when systolic blood pressure was less than or equal to baseline and stopped the infusion when systolic blood pressure exceeded baseline. Up to uterine incision, 94.6% of all systolic blood pressure measurements were within the range (baseline +/- 20%). Seven patients (13.2%) had one or more episodes of hypotension (systolic blood pressure < 80% of baseline) and 23 patients (37.7%) had one or more episodes of hypertension (systolic blood pressure > 120% of baseline). No patient had nausea or vomiting and in no case was umbilical arterial blood pH < 7.2. Calculated system performance parameters were comparable with those of previously published closed-loop systems and provide a reference for the potential development and comparison of more advanced algorithms.

Publication types

  • Evaluation Study
  • Research Support, Non-U.S. Gov't

MeSH terms

  • Adult
  • Algorithms
  • Anesthesia, Obstetrical / adverse effects*
  • Anesthesia, Spinal / adverse effects*
  • Blood Pressure / drug effects
  • Cesarean Section*
  • Drug Administration Schedule
  • Drug Delivery Systems / methods
  • Drug Therapy, Computer-Assisted / methods
  • Feasibility Studies
  • Feedback
  • Female
  • Humans
  • Hypotension / etiology
  • Hypotension / prevention & control*
  • Intraoperative Complications / prevention & control
  • Phenylephrine / administration & dosage*
  • Phenylephrine / therapeutic use
  • Pregnancy
  • Vasoconstrictor Agents / administration & dosage*
  • Vasoconstrictor Agents / therapeutic use

Substances

  • Vasoconstrictor Agents
  • Phenylephrine