Spinal anesthesia with hyperbaric bupivacaine: A comparison of hypertensive and normotensive patients

Abstract

BackgroundHypotension is the most common problem with spinal anesthesia. This prospective study aimed to compare normotensive and hypertensive patients with respect to the hemodynamic effects of spinal anesthesia performed with hyperbaric bupivacaine.Material/MethodsSixty patients who were scheduled to undergo various elective operations under spinal anesthesia were included into the study. The patients were separated into 2 groups: hypertensive patients constituted Group H (n=30) and normotensive patients constituted Group N (n=30). After fluid loading, spinal anesthesia was performed with 3.5 ml 0.5% hyperbaric bupivacaine. Demographic characteristics and incidence of hypotension and bradycardia were compared. Systolic (SBP), diastolic (DBP), and mean blood pressures (MBP) and heart rate (HR) were also compared before and after spinal anesthesia.ResultsThere was no significant difference between the groups with respect to demographic characteristics, maximal height of sensory block, incidences of hypotension and bradycardia, and the amount of fluids infused (p>0.05). In the hypertensive patient group, the SBP, DBP, and MBP values were significantly higher than in the normotensive patient group at all measurement times (p<0.05). Comparison within the groups did not reveal any significant differences in either group compared to the basal values (p>0.05). There were no significant differences in HR between or within groups (p>0.05).ConclusionsThere was no significant difference between normotensive and hypertensive patients in the incidences of hypotension caused by spinal anesthesia with 0.5% hyperbaric bupivacaine.

Comparison of Hemodynamic Response following Spinal Anesthesia between Controlled Hypertensive and Normotensive Patients Undergoing Surgery below the Umbilicus: An Observational Prospective Cohort Study

“…e incidence of hypotension was 20% (6 out of 30) in controlled hypertension and 3.3% (1 out of 30) in the normotensive group. Another similar study, which was 1 or 2 decades older than ours, showing that the incidence of hypotension between controlled hypertension and normotensive patients was 55.5% and 43.8%, respectively, and this was also not statistically significant (p > 0.05) [14].…”

“…e data structured questionnaire was prepared in English. e questionnaire was adapted from different articles with some modifications [14][15][16][17]. e data collection was done by four anesthetists and supervised by one anesthetist that has experience in research.…”

A Comparison of Intravenous Ephedrine or Phenylephrine, for Prevention of Postspinal Hypotension during Elective Lower Abdominal Surgery: A Randomized, Double-blind Case–control Study

“…Our study is not consistent with the work of resent researchers whom studied on ephedrine and phenylephrine for prevention of hypotension during spinal block for cesarean section and effects on fetus and they concluded that ephedrine was more effective than phenylephrine in the prevention of hypotension. [ 14 15 16 17 ] This may have been because more dose of phenylephrine was used in their study as compared with this study and on the other hand they studied only on cesarean section, which needs different management than our study.…”

“…Nowadays spinal anesthesia is widely used for elective lower abdominal surgeries. [ 1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19 20 21 ] It is frequently accompanied by hypotension, which may be defined in absolute terms as a systolic blood pressure (SBP) less than 90 or 100 mmHg or in relative terms as a percentage (20% fall from baseline). [ 1 ] The severity of this hypotension depends on the height of the block, the position of the patient, and the volume status of them.…”

Hipotensión bajo anestesia regional subaracnoidea en población no obstétrica

“…Estos pacientes presentan un aumento en la actividad simpática y en los niveles de noradrenalina, lo cual induce cambios estructurales a nivel de la pared arteriolar 24 . Se ha encontrado una relación entre el grado de hipotensión postanestésica y las cifras tensionales preoperatorias 25,26 .…”