Development of a Guideline to Reduce Spinal Induced Hypotension and Related Nausea and Vomiting In Patients Undergoing Scheduled Cesarean Section

Author

Peter GillenFollow

Date of Award

Spring 5-9-2019

Document Type

DNP Project

Project Team Faculty Member

Mary Zerlan

Project Team Faculty Member

Kay Gahle

Project Team Faculty Member

Michelle Ertel

Keywords

spinal induced hypotension, nausea and vomiting, ondansetron, coloading, cesarean section

Abstract

Cesarean sections performed under spinal anesthesia frequently involve spinal-induced hypotension and can result in intraoperative nausea and vomiting for the patient. This project involved the development of a guideline to combat this problem using lower sequential devices, co-loading of crystalloid fluids, and prophylactic administration of intravenous ondansetron. The guideline was presented to anesthesia providers at a tertiary care facility in Southwestern Illinois. Evaluation of the project included pre and post-tests as well as post-implementation surveys of the providers. The pre-test results indicated a need for further education among providers to address the problem. The post-test scores achieved the goal of educating providers while the post-implementation surveys show a decrease in the use of vasopressors, a decrease in hypotensive episodes, and a decrease in intraoperative nausea and vomiting as reported by anesthesia providers. Although the sample size does not allow for generalizability of data, the interventions applied show positive results that should continue to be used to produce a larger sample and allow for further analysis.

Recommended Citation

Gillen, Peter, "Development of a Guideline to Reduce Spinal Induced Hypotension and Related Nausea and Vomiting In Patients Undergoing Scheduled Cesarean Section" (2019). Doctor of Nursing Practice Projects. 42.
https://spark.siue.edu/dnpprojects/42

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