Spinal Anesthesia for Women with Quadruplet Pregnancy: A Preventive Approach to Decrease the Incidence of Nausea, Vomiting, and Hypotension During Cesarean Section

Hönemann CW1*, Hagemann O1 and Rübsam ML2

1Department of Anesthesia Critical Care and Pain Therapy, Marienhospital Vechta, Teaching Hospital of Medical University Hannover, University of Muenster, Germany
2Department of Anesthesiology and Intensive Medicine, Emergency and Pain, University of Greifswald, Germany

^*Correspondance to: Christian Hönemann 

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Abstract:

The incidence rates of triplet (0.09%) and quadruplet pregnancies (0.003%) are low, and considering the absence of established protocols anesthesia must be planned accurately. From the perspective of an anesthesiologist, elective cesarean sections in patients with multifetal pregnancies should be performed using SPA. Literature suggests the use of hyperbaric bupivacaine in combination with an intrathecally administered opioid to avoid side effects (nausea, vomiting, and hypotension). Patient blood management and all measures to treat anemia and reduce intraoperative blood loss are necessary (Misgav-Ladach Cesarean technique, normothermia, normocalcemia, balanced gas exchange). Hyperfibrinolysis should be interrupted by tranexamic acid.

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Cite the Article:

Hönemann CW, Hagemann O, Rübsam ML. Spinal Anesthesia for Women with Quadruplet Pregnancy: A Preventive Approach to Decrease the Incidence of Nausea, Vomiting, and Hypotension During Cesarean Section. Ann Clin Case Rep. 2023; 8: 2541.