Comparison of Haemodynamic Profile After Spinal Anaesthesia in Patients on Regular Treatment With Calcium Channel Blockers and Β Blockers

Kavyashree, N G; Patel, Muralidhara Danappa; Girish, C N; Ravishankar, R

doi:10.14260/jemds/2016/455

Cited by 2 publications

(1 citation statement)

References 15 publications

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“…The preservation of hemodynamic stability during anesthesia is a significant issue for anesthetists, especially for hypertensive patients. The risk of profound hypotension and associated management dilemma make anesthesiologists refuse to perform SAB in hypertensive subjects [2].…”

Section: Introductionmentioning

confidence: 99%

A Comparative Study of Hemodynamic Parameters Following Subarachnoid Block in Patients With and Without Hypertension

Panda¹,

Muni²,

Nanda³

2022

Cureus

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BackgroundHypotension is common in patients receiving a subarachnoid block (SAB) and can decrease vital organ perfusion, causing increased morbidity and mortality. Patients may receive intraoperative intravenous (IV) fluids and rescue medications to avoid these adverse effects and maintain adequate hemodynamic parameters. We conducted this study to compare the hemodynamic parameters and heart rate following spinal anesthesia on patients receiving antihypertensive medications (e.g., calcium channel blockers with or without beta-blockers) with those without hypertension during surgical procedures requiring SAB. MethodsWe conducted this two-year, single-center, prospective observational study in patients with hypertension and blood pressure within reference ranges receiving elective surgical procedures that do not require a definitive airway. All participants were from the American Society of Anesthesiologists physical status I and II. We assigned patients into three groups. Group 1 consisted of patients with hypertension receiving calcium channel blockers. Group 2 consisted of patients with hypertension receiving calcium channel blockers with beta-blockers. Patients whose blood pressure was within reference range were assigned to group 3. We collected patient ages and body weights, and we compared heart rate (HR), systolic and diastolic blood pressure (SBP; DBP), and mean arterial pressure (MAP) between the groups. We also compared the use of intraoperative rescue medications, IV fluid administration, and patient outcomes. We used Epi Info version 7.1 (Atlanta, GA: Centers for Disease Control and Prevention) public domain software for statistical analysis. ResultsSeventy-eight patients were included in the study (41 men, 37 women); group 1, HR, SBP, DBP, and MAP significantly declined over time in all groups, but there were no significant differences when comparing parameters between groups. Hypotension occurred in significantly more patients in group 1 (p=0.02) than groups 2 and 3. Bradycardia was experienced by significantly more patients in group 2 (p<0.05) than group 1 and group 3. Twenty-four patients in group 3, 17 patients in group 1, and 14 patients in group 2 required IV fluid in the first 20 minutes of the procedure, and the differences between the groups were not significant. Likewise, 15 patients in group 3, 14 in group 1, and 10 in group 2 required ephedrine, but the differences were not significant. ConclusionsWe compared intraoperative hemodynamic parameters following spinal anesthesia on patients receiving antihypertensive medications with patients without hypertension following SAB. Our results showed no meaningful differences in hemodynamic parameters between patients receiving antihypertensive drugs (calcium channel blockers without or in combination with beta-blockers) and those not receiving antihypertensive drugs after SAB. Therefore, calcium channel blockers alone or in combination with betablockers can be used to control patient blood pressure prior to surgery.

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Section: Introductionmentioning

confidence: 99%

A Comparative Study of Hemodynamic Parameters Following Subarachnoid Block in Patients With and Without Hypertension

Panda¹,

Muni²,

Nanda³

2022

Cureus

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An Observational Study to Compare Spinal Anesthesia-Induced Hemodynamic Changes in Normotensive and Hypertensive Patients on Antihypertensive Medications

DOHARE,

VATSALYA,

MEHROTRA

2024

Asian J Pharm Clin Res

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Background: Spinal anesthesia is a popular and widely used anesthetic technique for lower abdominal, pelvic, and lower limb surgery. It has proven to be a convenient, economical, and easily motivated technique that provides excellent anesthesia and post-operative analgesia. Hypotension and bradycardia occur frequently following spinal anesthesia due to blockade of sympathetic outflow. Antihypertensive agents decrease this effect by controlling blood pressure. There are conflicting reports on the continuation of antihypertensive drugs on the day of surgery in patients undergoing spinal anesthesia. Sudden hypotension could have detrimental effect on the organ systems. This study was undertaken to compare the spinal anesthesia-induced hemodynamic changes in normotensive and in hypertensive patients on antihypertensive therapy. Methods: The study was conducted in the Department of Anesthesiology, Gandhi Medical College, and associated Hamidia Hospital Bhopal during January 2019–July 2020. It was an observational study conducted on 100 patients of ASA Grade 2 and Grade 3 in the age group between 35 and 60 years. Undergoing lower limb surgery under spinal anesthesia, patients were allocated into two groups: Group N (n=50) normotensive and Group H (n=50) hypertensive patients receiving antihypertensive medication. Results: Incidence of hypotension was significantly higher in Group II patients. Single episode of hypotension was seen in 12 (24.0%) patients in Group I and 33 (66.0%) in Group II patients respectively. Three episodes of hypotension were seen in 3 (6.0%) Group I and 4 (8.0%) Group II patients, respectively. The frequency of administration of mephentermine was 2 times more significant in Group II who required treatment with mephentermine more than twice as compared to Group I (p=0.001). There was statistically no significant difference found in mean Heart rate between Group I (normotensive) and Group II (hypertensive), respectively (p>0.05). Conclusion: Antihypertensive medications decreased the incidence of hypotension by controlling blood pressure but their varying effects on the cardiovascular system might alter the hemodynamics during the initial phase of subarachnoid block. We found that patients on antihypertensive therapy (calcium channel blockers) had increased incidence of intraoperative hypotension after SAB and when compared to normotensive patients required vasopressors more often to maintain normal blood pressure.

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Comparison of Haemodynamic Profile After Spinal Anaesthesia in Patients on Regular Treatment With Calcium Channel Blockers and Β Blockers

Cited by 2 publications

References 15 publications

A Comparative Study of Hemodynamic Parameters Following Subarachnoid Block in Patients With and Without Hypertension

A Comparative Study of Hemodynamic Parameters Following Subarachnoid Block in Patients With and Without Hypertension

An Observational Study to Compare Spinal Anesthesia-Induced Hemodynamic Changes in Normotensive and Hypertensive Patients on Antihypertensive Medications

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