CLINICS

Clinics (Sao Paulo). 2010 August; 65(8): 793-798.
doi:10.1590/S1807-59322010000800010

Copyright © 2010 Hospital das Clínicas da FMUSP

Clinical evaluation of the flotrac/vigileo™ system for continuous cardiac output monitoring in patients undergoing regional anesthesia for elective cesarean section: a pilot study

José Otavio C. Auler 1 , Marcelo L. A. Torres 1 , Mônica M. Cardoso 1 , Thais C. Tebaldi 1 , André P. Schmidt 1 2 , Mario M. Kondo 3 , Marcelo Zugaib 3

Department of Anesthesia, Instituto Central, Hospital das Clínicas, Universidade de São Paulo – São Paulo/SP, Brazil

Anesthesia and Perioperative Medicine Service, Hospital de Clínicas de Porto Alegre (HCPA) – Porto Alegre, Brazil

Department of Obstetrics and Gynecology, Hospital das Clínicas, Universidade de São Paulo – São Paulo/SP, Brazil

E-mail: auler@hcnet.usp.br Tel.: 5511 3069-5367

received May 16, 2010; revised May 16, 2010; accepted May 25, 2010.

Abstract

BACKGROUND:

Spinal anesthesia for cesarean delivery may cause severe maternal hypotension and a decrease in cardiac output. Compared to assessment of cardiac output via a pulmonary artery catheter, the FloTrac/Vigileo™ system may offer a less invasive technique. The aim of this study was to evaluate cardiac output and other hemodynamic measurements made using the FloTrac/Vigileo™ system in patients undergoing spinal anesthesia for elective cesarean section.

METHODS:

A prospective study enrolling 10 healthy pregnant women was performed. Hemodynamic parameters were continuously obtained at 15 main points: admission to surgery (two baseline measurements), after preload, after spinal anesthesia administration and 4 time points thereafter (4, 6, 8 and 10 min after anesthesia), at skin and uterine incision, newborn and placental delivery, oxytocin administration, end of surgery, and recovery from anesthesia. Hemodynamic therapy was guided by mean arterial pressure, and vasopressors were used as appropriate to maintain baseline values. A repeated measures ANOVA was used for data analysis.

RESULTS:

There was a significant increase in heart rate and a decrease of stroke volume and stroke volume index up to 10 min after spinal anesthesia (P < 0.01). Importantly, stroke volume variation increased immediately after newborn delivery (P < 0.001) and returned to basal values at the end of surgery. Further hemodynamic parameters showed no significant changes over time.

DISCUSSION AND CONCLUSIONS:

No significant hemodynamic effects, except for heart rate and stroke volume changes, were observed in pregnant women managed with preload and vasopressors when undergoing elective cesarean section and spinal anesthesia.

Keywords: FloTrac/Vigileo™, Cardiac output, Stroke volume, Cesarean section, Spinal anesthesia


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