Positional changes in blood pressure and heart rate as a predictor of post-spinal hypotension in patients undergoing elective caesarean section: An observational study
European Journal of Molecular & Clinical Medicine,
2022, Volume 9, Issue 4, Pages 4010-4018
AbstractBackground: The most widely used anaesthesia technique for caesarean section is spinal anaesthesia, however hypotension is the most frequent complication of spinal anaesthesia in pregnant patients. This study was designed to evaluate whether or not the changes in blood pressure and heart rate obtained prior to spinal anesthesia in different positions, would be useful to predict a subset of pregnant patients that might be at high risk for post spinal hypotension.
Aim: To record the positional changes in blood pressure and heart rate in patients undergoing elective caesarean delivery and to study the correlation of positional changes in blood pressure and heart rate with post spinal hypotension in these patients.
Methods: The study was conducted at Lalla Ded Hospital which is an associated hospital of Government Medical College, Srinagar. Total number of patients studied was 65 who were term parturient (≥37 weeks gestation) with singleton pregnancy. Patients with multiple pregnancy or with preexisting diseases like hypertension, preeclampsia, eclampsia, diabetes, cardiovascular, renal, hepatic or thyroid diseases were excluded from the study. In this study the changes in the systolic, diastolic, mean arterial pressure and heart rate in various positions (supine, right lateral, and sitting) was measured. Then, the patients underwent spinal anesthesia for caesarean section and again the systolic and diastolic blood pressures, mean arterial pressure and heart rate were measured and recorded.
Results: Positional change (Right lateral-Supine) in Systolic Blood Pressure, Diastolic blood Pressure, MAP and Heart Rate in Hypotensive and non-hypotensive groups was statistically significant (P-value < 0.05). Positional change (Sitting-Supine) in Systolic Blood Pressure and Heart Rate in Hypotensive and non-hypotensive groups was statistically significant (P-value < 0.05) whereas the positional change (Sitting-Supine) in Diastolic Blood Pressure and
MAP was statistically insignificant with P-values 0.177 and 0.60 respectively.
Conclusion: Higher the blood pressure and heart rate variation in different positions (supine/sitting and lateral), the higher the probability of post spinal hypotension. The blood pressure and Heart rate variation in the lateral position from base line (supine) is statistically more significant than sitting position.
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