Analysis of Risk Factors for Intraoperative Hypotension in Cesarean Section and Poor Prognosis of Neonates

Liu, Yang; Qian, Yanning

doi:10.1155/2022/2468114

Cited by 5 publications

(17 citation statements)

References 29 publications

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“…This finding is consistent with a study at Sriraj Hospital stating that a high dose of bupivacaine is a modifiable risk factor for SAIH [14]. Although our study showed no association between the SA puncture and hypotension level, another study indicated that the SA puncture level at L2-L3 is associated with hypotension [18].…”

Section: Discussionsupporting

confidence: 92%

Incidence and Risk Factors of Spinal Anesthesia-Related Complications After an Elective Cesarean Section: A Retrospective Cohort Study

Algarni¹,

Albakri²,

Albakri³

et al. 2023

Cureus

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IntroductionNeuraxial anesthetic techniques are the method of choice for cesarean section (CS) deliveries, and spinal anesthesia (SA) is the preferred technique. Although the use of SA has greatly improved the outcomes of CS deliveries, SA-related complications are still a matter of concern. The study's primary aim is to measure the incidence of SA complications after a CS, specifically hypotension, bradycardia, and prolonged recovery, as well as to identify the risk factors for these complications. MethodThe data of patients who had elective CS using SA from January 2019 to December 2020 was collected from a tertiary hospital in Jeddah, Saudi Arabia. The study design was a retrospective cohort study. The data collected included age, BMI, gestational age, comorbidities, the SA drug and dosage used, the site of the spinal puncture, and the patient's position during the spinal block. Also, the patient's blood pressure measurements, heart rate, and oxygen saturation levels were collected at baseline and at 5, 10, 15, and 20 minutes. SPSS was used for statistical analysis. ResultsThe incidence of mild, moderate, and severe hypotension was 31.4%, 23.9%, and 30.1%, respectively. In addition, 15.1% of the patients experienced bradycardia, with 37.4% experiencing a prolonged recovery. Two factors were associated with hypotension, including BMI and the dosage of the SA, with a p-value of 0.008 and a p-value of 0.009, respectively. The site of the SA punctures equal to or lower than L2 was the only factor associated with bradycardia (p-value = 0.043). ConclusionThe present study concludes that BMI and the dose of SA were the factors associated with SA-induced hypotension during a CS, and the site of the SA puncture equal to or lower than L2 was the only risk factor associated with spinal anesthesia-induced bradycardia.

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Section: Discussionsupporting

confidence: 92%

Incidence and Risk Factors of Spinal Anesthesia-Related Complications After an Elective Cesarean Section: A Retrospective Cohort Study

Algarni¹,

Albakri²,

Albakri³

et al. 2023

Cureus

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“…Subsequently, a detailed examination of full-text articles resulted in the exclusion of 14 studies. Ultimately, 12 studies successfully satisfied the established criteria and were included in the review [15,17,18,[22][23][24][25][26][27][28][29][30]. The characteristics of the 11 studies involving 2009 patients are summarized in Table 1.…”

Section: Study Selection and Study Characteristicsmentioning

confidence: 99%

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

et al. 2023

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This meta-analysis assessed the predictive efficacy of perfusion index for hypotension following spinal anesthesia (SA) in parturients undergoing elective cesarean section (CS). Electronic databases, including Google Scholar, EMBASE, Cochrane Library, and MEDLINE, were searched from inception to June 2023. The primary outcome was the diagnostic accuracy of the perfusion index in predicting the probability of perioperative hypotension following SA. The review included 12 studies involving 2009 patients, published between 2017 and 2023. The pooled sensitivity and specificity were 0.81 (95% confidence interval (CI) = 0.72–0.87) and 0.75 (95% CI = 0.67–0.82), respectively. Additionally, the pooled area under the curve (AUC) was calculated as 0.84 (95% CI = 0.81–0.87), suggesting a moderate to good accuracy of the diagnostic test. Using Fagan’s nomogram plot, the positive likelihood ratio (LR) and negative LR were found to be 3 and 0.26, respectively. The results demonstrated that the perfusion index exhibited an acceptable level of accuracy in predicting perioperative hypotension after spinal anesthesia in parturients undergoing elective CS. These findings highlight the potential value of incorporating a perfusion index as a useful tool for clinicians to integrate into routine clinical practice, which necessitates further large-scale studies for verification.

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“…Patient-related factors include advanced age, pregnancy, obesity, diabetes mellitus (DM), anemia, and hypertension. On the other hand, technical considerations include the presence of a block level at or above T5, administration of large doses of local anesthetics, and use of opioids during premedication ( 9 , 10 ).…”

Section: Introductionmentioning

confidence: 99%

Intrathecal Injection of Hyperbaric Bupivacaine Versus a Mixture of Hyperbaric and Isobaric Bupivacaine in Lower Abdominal Surgery: A Randomized Controlled Trial

Hassan,

Saleh,

Mohamed

et al. 2024

Anesth Pain Med

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Background: Bupivacaine hydrochloride is widely used as the primary drug for spinal anesthesia. Objectives: This research aimed to evaluate the intrathecal administration of both isobaric and hyperbaric bupivacaine (HB) in lower abdominal surgery. Methods: A randomized, controlled, double-blind trial was conducted on 50 patients classified as American Society of Anesthesiologists (ASA) class I to II, scheduled for lower abdominal surgery under spinal anesthesia. The patients were allocated randomly into two groups of similar size. Group A (control group) received 20 mg HB 0.5% intrathecally. Group B (case group) received 10 mg HB 0.5% and 10 mg isobaric bupivacaine (IB) 0.5%. Results: There was a significant decline in heart rate and mean arterial pressure in Group A compared to Group B (P < 0.05). Group A had a significantly greater sensory level at 10 and 20 minutes than Group B (P = 0.008 and 0.006, respectively). Group A had an earlier duration in reaching Bromage 3 and the first need for analgesia, compared to group B (P = 0.001 and 0.003, respectively). Conclusions: In lower abdominal surgery, the intrathecal administration of HB with IB increased hemodynamic stability and duration of both sensory and motor blockade but with slower recovery from anesthesia compared to HB alone.

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Analysis of Risk Factors for Intraoperative Hypotension in Cesarean Section and Poor Prognosis of Neonates

Cited by 5 publications

References 29 publications

Incidence and Risk Factors of Spinal Anesthesia-Related Complications After an Elective Cesarean Section: A Retrospective Cohort Study

Incidence and Risk Factors of Spinal Anesthesia-Related Complications After an Elective Cesarean Section: A Retrospective Cohort Study

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

Intrathecal Injection of Hyperbaric Bupivacaine Versus a Mixture of Hyperbaric and Isobaric Bupivacaine in Lower Abdominal Surgery: A Randomized Controlled Trial

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