Strategies for Prevention of Spinal-associated Hypotension During Cesarean Delivery: Are We Paying Attention?
Bibliographic record
Abstract
( Can J Anaesth 2017;64:991–996) Spinal anesthesia (SA)-induced hypotension is a common complication during cesarean delivery (CD) and can cause a wide range of adverse maternal and neonatal outcomes if untreated. Moore et al’s clinical trial aimed at assessing the median seated time to prevent hypotension in 50% of parturients undergoing elective CD after SA using an up-down sequential methodology. The participants were randomized to receive either 11.25 or 15 mg hyperbaric bupivacaine along with fentanyl 15 µg and morphine 150 µg. It was noted that the median seated time in the 11.25 mg bupivacaine group was a little more than 2 minutes whereas in the 15 mg bupivacaine group the median seated time was approximately 8 minutes, suggesting that extended seated time after SA could prevent hypotension in CD. Further studies elucidating the association of extended seated time and hypotension are essential to design effective prevention strategies for hypotension in CD. The current study was only powered to detect the intervention that prevented hypotension in 50% of patients, which questions its clinical relevance. Disadvantages of the prolonged seated strategy include a delay in surgical start time, reduced operating room efficiency, and shorter duration of anesthesia.
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How this classification was reachedexpand
Full frame distilled prediction
Teacher imitationNot calibrated prevalence, not ground truth. Human validation pending. Learned from the 10,348 direct Codex labels and 10,348 direct Gemma labels. Candidate is the union of thresholded teacher heads; consensus is their intersection. These outputs are machine_predicted_unvalidated and are not human labels or direct frontier model labels.
Codex and Gemma teacher scores by category
| Category | Codex | Gemma |
|---|---|---|
| Metaresearch | 0.000 | 0.000 |
| Meta-epidemiology (narrow) | 0.000 | 0.000 |
| Meta-epidemiology (broad) | 0.000 | 0.000 |
| Bibliometrics | 0.000 | 0.001 |
| Science and technology studies | 0.000 | 0.000 |
| Scholarly communication | 0.000 | 0.000 |
| Open science | 0.000 | 0.000 |
| Research integrity | 0.000 | 0.000 |
| Insufficient payload (model declined to judge) | 0.000 | 0.000 |
Machine scores (provisional)
The two teacher heads of the student model, read on this work. A score orders the frame for review; it never asserts a category, and the validation status ships verbatim with every row.
Baseline scores from an immature model (maturity gate not passed, 7 training rounds). Scores rank; they never assert a category.
score_only:v0-immature-baseline · verbatim from the scoring run: score_only means the number may rank works, and no category label ships from itClassification
machine, unvalidatedMachine predicted; a candidate call from one teacher head, not a consensus.
How this classification was reached, model by model and score by score, is at the end of the page under "How this classification was reached".