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Discussion

obstetrical surgery and boluses

I am a relatively new ob nurse taking perianaesthetic courses (long story). In simple terms (i.e. obstetrical nurses for dummies) why do we give boluses prior to c-sections? I know during surgery, with anaesthesia our blood pressure drops but physiologically, why? :confused: Thanks

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    You are giving prophylactic IV ephedrine to prevent maternal drop in BP r/t spinal anesthesia becausing giving a rescue bolus alone is not as effective as giving a prophylactic dose and a rescue does if systolic BP drops below 90.

    As for BP dropping during anesthesia, it can be caused initially by the vasodilating effects of the anesthesia causing increased blood flow and decreased pressure. This, however, is usually corrected by itself when the body reacts to the cutting of surgery and invasive procedures by producing hormones (epinephrine and norepinephrine) for vasoconstriction. Then of course the blood loss. Usually during a C-section the average blood loss is about 500cc of blood. Then there can be a reaction to the anesthesia or other underlying pathophysiology like cardiac problems causing a drop in BP. The anesthesiologist gives meds to correct the problem.

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    Thanks-my brain is not working today:hug:

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    I was just going to say it's similar to filling the tank with gas before you leave on a long trip. :)

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