Low-dose spinal anesthesia with low-dose phenylephrine infusions for cesarean delivery: better but not necessarily best.

摘要

To the Editor:-We read with interest the recently published report by Langesaeter et al. together with the accompanying editorial, describing the use of minimally invasive continuous cardiac output monitoring during spinal anesthesia for cesarean delivery. Based on derived values for cardiac output, the authors advocated allowing a 10 to 20% decrease in blood pressure and questioned as unnecessary the use of higher doses of phenylephrine given to maintain blood pressure near baseline. The findings from this paper are important and are a substantial contribution to our knowledge of the hemodynamic changes during regional anesthesia in parturients. However, we believe that some caution is required when extrapolating these findings to recommendations for everyday clinical practice.