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Baseline heart rate may predict hypotension after spinal anesthesia in prehydrated obstetrical patients.
Can J Anaesth. 2002 Feb; 49(2):185-9.CJ

Abstract

PURPOSE

Hypotension is the most frequent complication of spinal anesthesia in pregnant patients. This study was designed to identify patients at risk for postspinal hypotension based on preoperative vital signs before and after an orthostatic challenge.

METHODS

Forty healthy women scheduled for elective Cesarean section were enrolled in this prospective trial. Blood pressure (BP) and heart rate (HR) were recorded with the patient in the lateral supine position and after standing up. After a bupivacaine spinal anesthetic, BP was obtained every two minutes for 30 min. Ephedrine treatment was administered based on the degree of hypotension observed. Hemodynamic parameters were correlated to ephedrine requirements (Spearman's rank order correlation).

RESULTS

There was a significant correlation in baseline maternal HR and ephedrine requirements (P=0.005). The degree of orthostatic changes in mean arterial BP and HR did not correlate with postspinal hypotension.

CONCLUSIONS

Baseline HR may be predictive of obstetric spinal hypotension. Higher baseline HR, possibly reflecting a higher sympathetic tone, may be a useful parameter to predict postspinal hypotension.

Authors+Show Affiliations

Department of Anesthesiology, University of Florida College of Medicine, Gainesville, Florida 32610, USA. froelich@anest.ufl.eduNo affiliation info available

Pub Type(s)

Journal Article
Research Support, Non-U.S. Gov't

Language

eng

PubMed ID

11823398

Citation

Frölich, Michael A., and Donald Caton. "Baseline Heart Rate May Predict Hypotension After Spinal Anesthesia in Prehydrated Obstetrical Patients." Canadian Journal of Anaesthesia = Journal Canadien D'anesthesie, vol. 49, no. 2, 2002, pp. 185-9.
Frölich MA, Caton D. Baseline heart rate may predict hypotension after spinal anesthesia in prehydrated obstetrical patients. Can J Anaesth. 2002;49(2):185-9.
Frölich, M. A., & Caton, D. (2002). Baseline heart rate may predict hypotension after spinal anesthesia in prehydrated obstetrical patients. Canadian Journal of Anaesthesia = Journal Canadien D'anesthesie, 49(2), 185-9.
Frölich MA, Caton D. Baseline Heart Rate May Predict Hypotension After Spinal Anesthesia in Prehydrated Obstetrical Patients. Can J Anaesth. 2002;49(2):185-9. PubMed PMID: 11823398.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Baseline heart rate may predict hypotension after spinal anesthesia in prehydrated obstetrical patients. AU - Frölich,Michael A, AU - Caton,Donald, PY - 2002/2/2/pubmed PY - 2002/5/25/medline PY - 2002/2/2/entrez SP - 185 EP - 9 JF - Canadian journal of anaesthesia = Journal canadien d'anesthesie JO - Can J Anaesth VL - 49 IS - 2 N2 - PURPOSE: Hypotension is the most frequent complication of spinal anesthesia in pregnant patients. This study was designed to identify patients at risk for postspinal hypotension based on preoperative vital signs before and after an orthostatic challenge. METHODS: Forty healthy women scheduled for elective Cesarean section were enrolled in this prospective trial. Blood pressure (BP) and heart rate (HR) were recorded with the patient in the lateral supine position and after standing up. After a bupivacaine spinal anesthetic, BP was obtained every two minutes for 30 min. Ephedrine treatment was administered based on the degree of hypotension observed. Hemodynamic parameters were correlated to ephedrine requirements (Spearman's rank order correlation). RESULTS: There was a significant correlation in baseline maternal HR and ephedrine requirements (P=0.005). The degree of orthostatic changes in mean arterial BP and HR did not correlate with postspinal hypotension. CONCLUSIONS: Baseline HR may be predictive of obstetric spinal hypotension. Higher baseline HR, possibly reflecting a higher sympathetic tone, may be a useful parameter to predict postspinal hypotension. SN - 0832-610X UR - https://www.unboundmedicine.com/medline/citation/11823398/Baseline_heart_rate_may_predict_hypotension_after_spinal_anesthesia_in_prehydrated_obstetrical_patients_ L2 - https://doi.org/10.1007/BF03020493 DB - PRIME DP - Unbound Medicine ER -