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Hypotension After Spinal Anesthesia for Cesarean Section: Identification of Risk Factors Using an Anesthesia Information Management System

Overview
Publisher Springer
Date 2009 Mar 12
PMID 19277879
Citations 17
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Abstract

Objective: To determine risk factors for developing hypotension after spinal anesthesia for cesarean section to prevent obstetric patients from hypotensive episodes potentially resulting in intrauterine malperfusion and endangering the child.

Methods: The data from 503 women, having received spinal anesthesia for cesarean sections were investigated using online gathered vital signs and specially checked manual entries employing an anesthesia information management system. Blood pressure, heart rate, and oxygen saturation were measured throughout and hypotension was defined as either a drop in mean arterial blood pressure of >20% from baseline value or readings of <90 mmHg systolic arterial blood pressure. Thirty-two variables were studied for association with hypotensive episodes using univariate analysis and logistic regression employing a forward stepwise algorithm to identify independent variables (P < 0.05).

Results: Hypotension was found in 284 cases (56.5%). The univariate analysis identified the neonate's weight, mother's age, body mass index, and peak sensory block height associated with hypotension. Body mass index, age and sensory block height were detected as independent factors for hypotension (odds-ratio: 1.61 each).

Conclusions: Knowledge of these risk factors should increase the anesthesiologist's attention to decide for the necessity to employ prophylactic or therapeutic techniques or drugs to prevent the neonate from any risk resulting of hypotension of the mother.

Citing Articles

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Perfusion index to predict post spinal hypotension in lower segment caesarean section.

Harde M, Ranale P, Fernandes S J Anaesthesiol Clin Pharmacol. 2024; 40(1):37-42.

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The diagnostic accuracy of preoperative perfusion index as a predictor of postspinal anesthesia hypotension in parturients undergoing cesarean delivery: A prospective non-blinded observational study.

Kesavankutty M, Panda C, Karim H, Singha S, Agrawal S Saudi J Anaesth. 2024; 18(1):23-30.

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Comparison of the hemodynamic changes between preeclamptic and normotensive parturients who underwent cesarean section under spinal anesthesia at North Showa zone public hospitals, Oromia region, Ethiopia, 2022: a prospective cohort study.

Belachew B, Kasahun B, Demissie B, Sintayhu A, Dendir G, Ali A BMC Anesthesiol. 2023; 23(1):387.

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Predictive Efficacy of the Perfusion Index for Hypotension following Spinal Anesthesia in Parturient Undergoing Elective Cesarean Section: A Systematic Review and Meta-Analysis.

Hung K, Liu C, Huang Y, Wu J, Chen J, Ko C Diagnostics (Basel). 2023; 13(15).

PMID: 37568947 PMC: 10417716. DOI: 10.3390/diagnostics13152584.


References
1.
Scheler C, Ropke F . [Blood flow in the umbilical artery in maternal hypotension and after therapy with Pholedrine longo--a Doppler ultrasound study]. Z Geburtshilfe Perinatol. 1993; 197(4):191-4. View

2.
King S, Rosen M . Prophylactic ephedrine and hypotension associated with spinal anesthesia for cesarean delivery. Int J Obstet Anesth. 2004; 7(1):18-22. DOI: 10.1016/s0959-289x(98)80023-x. View

3.
Chan W, Irwin M, Tong W, Lam Y . Prevention of hypotension during spinal anaesthesia for caesarean section: ephedrine infusion versus fluid preload. Anaesthesia. 1998; 52(9):908-13. DOI: 10.1111/j.1365-2044.1997.190-az0323.x. View

4.
Hanss R, Bein B, Ledowski T, Lehmkuhl M, Ohnesorge H, Scherkl W . Heart rate variability predicts severe hypotension after spinal anesthesia for elective cesarean delivery. Anesthesiology. 2005; 102(6):1086-93. DOI: 10.1097/00000542-200506000-00005. View

5.
Hawkins J, Koonin L, Palmer S, Gibbs C . Anesthesia-related deaths during obstetric delivery in the United States, 1979-1990. Anesthesiology. 1997; 86(2):277-84. DOI: 10.1097/00000542-199702000-00002. View