Clinical Effectiveness of a Hemodynamic Risk-based Personalized Protocol During Combined Spinal-epidural Anesthesia
Year: 2026
Type: article
Study design: Clinical Trial
Abstract: Objective. To evaluate the clinical effectiveness of a personalized management protocol based on preoperative stratification of hemodynamic instability risk in multiparous pregnant women with anemia undergoing cesarean delivery under combined spinal-epidural anesthesia. Materials and methods. The prospective comparative study included 146 pregnant women with anemia of different etiologies. Seventy-two patients in the control group received standard anesthetic management, whereas 74 patients in the intervention group were managed using the SHIGUAN integral risk score followed by risk-adapted fluid and vasopressor support. Results. Personalized management was associated with more stable perioperative hemodynamics and a shorter time to stabilization. The incidence of intraoperative hypotension decreased from 43.1% to 24.3% (p=0.009; OR=0.43; 95% CI 0.22-0.85). Vasopressor, fluid and transfusion requirements were also reduced. Conclusion. Preoperative hemodynamic risk stratification followed by individualized perioperative support is associated with a lower incidence of hemodynamic instability during combined spinal-epidural anesthesia in multiparous pregnant women with anemia.
Source: Journal of modern medicine
Language: English
Subfield: Surgery
Field: Medicine
Domain: Health Sciences
Open Access status: hybrid
OpenAlex ID: W7222806964
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