Prediction of postspinal hypotension in elective caesarean section: An observational study
DOI:
https://doi.org/10.18231/j.joapr.2023.11.1.41.46Keywords:
Baseline heart rate, Caesarean section, postspinal hypotension, Spinal AnaesthesiaAbstract
Objectives: Spinal anaesthesia is the most preferred method of anaesthesia for a caesarean section. The frequent complication of the subarachnoid block is hypotension. This study aimed to find out the association of pre-operative heart rate with post-spinal hypotension. Materials and Methods: A total of 100 pregnant patients, ASA physical status І and ІІ, aged between 20-35 years, undergoing elective caesarean section, under spinal anaesthesia. The patient’s baseline heart rate, Systolic blood pressure, Diastolic blood pressure, Mean arterial pressure, and SPO2 were noted. Incidence of hypotension and mephentermine requirement following spinal anaesthesia noted. Results: Fifty-seven out of 100 patients developed hypotension (57.0%) of whom 48 were in the subgroup with HR >90bpm (67.0%) and 09 patients were in the group with HR < 90bpm (31.0%). The baseline heart rate was statistically significant with a p-value of 0.001. The average dose of mephentermine required to correct hypotension was 9.47±4.8 mg. Conclusion: Baseline heart rate is a promising predictor of postspinal hypotension in obstetric patients undergoing elective caesarean section.
Downloads
References
Klöhr S, Roth R, Hofmann T, Rossaint R, Heesen M. Definitions of hypotension after spinal anaesthesia for caesarean section: literature search and application to parturients. Acta Anaesthesiol Scand 54, 909-21. (2010).
Reiz S. Pathophysiology of Hypotension Induced by Spinal/Epidural Analgesia, Springer Berlin Heidelberg, 1986.
Corke BC, Datta S, Ostheimer GW, Weiss JB, Alper MH. Spinal anaesthesia for Caesarean section. The influence of hypotension on neonatal outcome. Anaesthesia 37, 658-62. (1982).
McCrae AF, Wildsmith JA. Prevention and treatment of hypotension during central neural block. Br J Anaesth 70, 672-80. (1993).
Jackson R, Reid JA, Thorburn J. Volume preloading is not essential to prevent spinal-induced hypotension at caesarean section. Br J Anaesth 75, 262-5. (1995).
Pomeranz B, Macaulay RJ, Caudill MA, Kutz I, Adam D, Gordon D, Kilborn KM, Barger AC, Shannon DC, Cohen RJ. Assessment of autonomic function in humans by heart rate spectral analysis. Am J Physiol 248, H151-3. (1985).
Hanss R, Bein B, Francksen H, Scherkl W, Bauer M, Doerges V, Steinfath M, Scholz J, Tonner PH. Heart rate variability-guided prophylactic treatment of severe hypotension after subarachnoid block for elective cesarean delivery. Anesthesiology 104, 635-43. (2006)
Buthelezi AS, Bishop DG, Rodseth RN, Dyer RA. Prophylactic phenylephrine and fluid co-administration to reduce spinal hypotension during elective caesarean section in a resource-limited setting: a prospective alternating intervention study. Anaesthesia 75, 487-92. (2020)
Fakherpour A, Ghaem H, Fattahi Z, Zaree S. Maternal and anaesthesia-related risk factors and incidence of spinal anaesthesia-induced hypotension in elective caesarean section: A multinomial logistic regression. Indian J Anaesth 62, 36-46. (2018).
Bargiela M, Kueper J, Serebrakian AT, Browne MR, Brogna S, Peacock ZS, Bojovic B, Shaw ND, Liao EC. Nasal Construction in Congenital Arhinia Due to Novel SMCHD1 Gene Variant. J. Craniofac. Surg., 00, 1–6 (2023)
Published
How to Cite
Issue
Section
Copyright (c) 2023 Kanchan Chauhan, Poornima N, Kshama Rao, Anupama Nagar
This work is licensed under a Creative Commons Attribution-NonCommercial 4.0 International License.
