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Positional blood pressure change and the risk of hypotension during spinal anesthesia for cesarean delivery: an observational study.
Anesth Analg. 2010 Sep; 111(3):712-5.A&A

Abstract

BACKGROUND

We investigated whether preoperative positional arterial blood pressure change predicted hypotension and ephedrine requirement during spinal anesthesia for cesarean delivery.

METHODS

Arterial blood pressure was measured in 66 women undergoing cesarean delivery in the supine and the right lateral positions. Positional blood pressure change was defined as the difference between mean blood pressure in the right lateral and supine positions. Hypotension (<80% baseline) was recorded, and severe hypotension (<70% baseline) was treated with ephedrine.

RESULTS

The mean (range) positional blood pressure change was 11 (3-29) mm Hg, and the incidence of hypotension was 41%. Positional blood pressure change and heart rate correlated with hypotension (P < 0.001 for both) and ephedrine requirement (P = 0.004). Positional blood pressure change in those who developed hypotension was higher than for those without hypotension (mean (SD), 17 (6) vs. 7 (2) mm Hg, P < 0.001).

CONCLUSIONS

A preoperative increase in blood pressure after position change may be a good variable to predict hypotension during spinal anesthesia for cesarean delivery.

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Authors+Show Affiliations

Jeon YT
Department of Anesthesia and Pain Medicine, Seoul National University Bundang Hospital, 300 Gumidong, Bundang, Seongnam, Kyonggi 463-707 South Korea.
Hwang JW
No affiliation info available
Kim MH
No affiliation info available
Oh AY
No affiliation info available
Park KH
No affiliation info available
Park HP
No affiliation info available
Lee Y
No affiliation info available
Do SH
No affiliation info available

MeSH

AdultAnesthesia, ObstetricalAnesthesia, SpinalBlood PressureCesarean SectionEphedrineFemaleHeart RateHumansHypotensionIntraoperative ComplicationsLogistic ModelsOdds RatioPostoperative PeriodPosturePregnancyRiskSupine PositionVasoconstrictor Agents

Pub Type(s)

Journal Article

Language

eng

PubMed ID

20686012

Clinical Trial Links

Association Between Preoperative Shock Index and Hypotension After Spinal Anaesthesia for Non- Elective Caesarean Section

Citation

Jeon, Young-Tae, et al. "Positional Blood Pressure Change and the Risk of Hypotension During Spinal Anesthesia for Cesarean Delivery: an Observational Study." Anesthesia and Analgesia, vol. 111, no. 3, 2010, pp. 712-5.
Jeon YT, Hwang JW, Kim MH, et al. Positional blood pressure change and the risk of hypotension during spinal anesthesia for cesarean delivery: an observational study. Anesth Analg. 2010;111(3):712-5.
Jeon, Y. T., Hwang, J. W., Kim, M. H., Oh, A. Y., Park, K. H., Park, H. P., Lee, Y., & Do, S. H. (2010). Positional blood pressure change and the risk of hypotension during spinal anesthesia for cesarean delivery: an observational study. Anesthesia and Analgesia, 111(3), 712-5. https://doi.org/10.1213/ANE.0b013e3181e8137b
Jeon YT, et al. Positional Blood Pressure Change and the Risk of Hypotension During Spinal Anesthesia for Cesarean Delivery: an Observational Study. Anesth Analg. 2010;111(3):712-5. PubMed PMID: 20686012.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Positional blood pressure change and the risk of hypotension during spinal anesthesia for cesarean delivery: an observational study. AU - Jeon,Young-Tae, AU - Hwang,Jung-Won, AU - Kim,Mi-Hyun, AU - Oh,Ah-Young, AU - Park,Kyo Hoon, AU - Park,Hee-Pyoung, AU - Lee,Younsuk, AU - Do,Sang-Hwan, Y1 - 2010/08/04/ PY - 2010/8/6/entrez PY - 2010/8/6/pubmed PY - 2010/9/11/medline SP - 712 EP - 5 JF - Anesthesia and analgesia JO - Anesth Analg VL - 111 IS - 3 N2 - BACKGROUND: We investigated whether preoperative positional arterial blood pressure change predicted hypotension and ephedrine requirement during spinal anesthesia for cesarean delivery. METHODS: Arterial blood pressure was measured in 66 women undergoing cesarean delivery in the supine and the right lateral positions. Positional blood pressure change was defined as the difference between mean blood pressure in the right lateral and supine positions. Hypotension (<80% baseline) was recorded, and severe hypotension (<70% baseline) was treated with ephedrine. RESULTS: The mean (range) positional blood pressure change was 11 (3-29) mm Hg, and the incidence of hypotension was 41%. Positional blood pressure change and heart rate correlated with hypotension (P < 0.001 for both) and ephedrine requirement (P = 0.004). Positional blood pressure change in those who developed hypotension was higher than for those without hypotension (mean (SD), 17 (6) vs. 7 (2) mm Hg, P < 0.001). CONCLUSIONS: A preoperative increase in blood pressure after position change may be a good variable to predict hypotension during spinal anesthesia for cesarean delivery. SN - 1526-7598 UR - https://www.unboundmedicine.com/medline/citation/20686012/Positional_blood_pressure_change_and_the_risk_of_hypotension_during_spinal_anesthesia_for_cesarean_delivery:_an_observational_study_ L2 - https://doi.org/10.1213/ANE.0b013e3181e8137b DB - PRIME DP - Unbound Medicine ER -