Data Layout for CESAREAN SECTION UNDER SPINAL OR EPIDURAL ANESTHESIA: INCIDENCE OF HYPOTENSION & BRADYCARDIA DURING TRANSPORT TO RECOVERY ROOM 1 Type of Anaesthesia 1=Spinal 2=Epidural 2 Orientation 1=Head Up 0=Horizontal 3 Patient ID Number 1 to 264 4 Patient's Weight lbs 5 Patient's Height inches 6 In Labor? 1=Yes 0=No 7 Emergency 1=Yes 0=No 8 Time Spinal/Epidural Given hour 9 Time Spinal/Epidural Given min 10 Highest Level of Neural Block Achieved -5(C3) to 3(T3) 11 Fluids given in OR units of 100 ml 12 Ephedrine Dose 13 Phenyleph Dose 14 OR Table Prior to Transfer "Time 1" hour 15 OR Table Prior to Transfer min 16 Level of Neural Block at end of OR-5(C3) to 3(T3) 17 Systolic BP at Time 1 mm 18 Diastolic BP at Time 1 mm 19 Pulse at Time 1 20 Nausea/Vomiting at time 1 1 = Yes 21 Intervention at Time 1 1 = Yes 22 Stretcher (hour) "Time 2" 23 Stretcher (min) "Time 2" 24 Systolic BP at Time 2 25 Diastolic BP at Time 2 26 Pulse at Time 2 27 Nausea/Vomiting at time 2 28 Intervention at Time 2 29 Stretcher (hour) "Time 3" 30 Stretcher (min) "Time 3" 31 Systolic BP at Time 3 32 Diastolic BP at Time 3 33 Pulse at Time 3 34 Nausea/Vomiting at time 3 35 Intervention at Time 3 CESAREAN SECTION UNDER SPINAL OR EPIDURAL ANESTHESIA: INCIDENCE OF HYPOTENSION & BRADYCARDIA DURING TRANSPORT TO RECOVERY ROOM Principal investigator: Dr. Sally Weeks, Department of Anaesthesia, RVH Co-investigator: Dr. Edith Bandi SHORT SUMMARY Hypotension and bradycardia can occur during spinal anesthesia. Sudden cardiac arrest in monitored patients has also occurred under spinal anesthesia. The period of transport from the OR table to the stretcher and then on to Recovery Room is a time when hypotension is particularly likely to occur and this may be accompanied by nausea / vomiting. There has been a recent cardiac arrest in Montreal just after arrival in the Recovery Room in a patient who had an uncomplicated spinal anesthetic for Cesarean Section. PROJECT DESIGN Number of patients - all patients having Cesarean Section under spinal or epidural anesthesia for a three-month period (approximately 200). For these reasons, we wish to determine the incidence of hypotension, bradycardia, nausea and vomiting in women who have had spinal anesthesia for Cesarean Section and compare these results with those having epidural anesthesia. This will be a prospective study and data will be recorded at three times: 1 on the table just prior to transfer to the stretcher (BP, Pulse); 2 on the stretcher just prior to leaving the OR, in the 30 degrees head-up position (BP, Pulse); 3 on arrival in Recovery Room (BP, Pulse). These measurements are always routinely recorded. We simply require permission to report them in a study. Consent for data to be used will be sought after the transport period, in the Recovery Room. Foreknowledge that the transfer period is the subject of a study could lead to cardiovascular responses independent of those induced by transport. Analysis of Results. The following will be determined: - Duration of transport period; - Incidence of significant hypotension, bradycardia, nausea/vomiting and need for drug therapy. The results of this study will determine whether a trial of a prophylactic vasopressor or vagolytic prior to transfer is warranted. Consent Form ROYAL VICTORIA HOSPITAL Department of Anaesthesia STUDY OF CHANGES IN BLOOD PRESSURE AND PULSE RATE AT TIME OF TRANSFER TO RECOVERY ROOM AFTER CESAREAN SECTION. We know that small changes in blood pressure and pulse rate may occur after surgery during transfer from the operating room table to the Recovery Room. We routinely measure blood pressure and pulse rate at time of transfer but now wish to use these data for a scientific study. There are no risks or benefits in taking part in the study. We merely ask your permission to use the data we already have for presentation. The knowledge we gain will help to guide our management of this postoperative period in the future. All data will be handled in a confidential manner and your name will not be used in the paper. Your participation is entirely voluntary and refusal to take part will not prejudice you in any way. I consent for the relevant data from my record to be used for scientific presentation.