The Incidence and Risk Factors for Hypotension After Spinal Anesthesia Induction: An Analysis with Automated Data Collection

Abstract

By using automated data collection, 5 (chronic alcohol consumption, history of hypertension, body mass index, sensory block height, and urgency of surgery) of 29 variables could be detected as having an association with hypotension after spinal anesthesia induction. The knowledge of these risk factors should be useful in increasing vigilance in those patients most at risk for hypotension, in allowing a more timely therapeutic intervention, or even in suggesting the use of alternative methods of spinal anesthesia, such as titrated continuous or small-dose spinal anesthesia.

A comparison of the effects of hyperbaric and isobaric bupivacaine spinalanesthesia on hemodynamics and heart rate variability

“…The reported rates of spinal anesthesia-induced hypotension in various studies range between 5% and 60%. This wide range is due to the description of hypotension, the time interval when blood pressure measurements are made, age, sex, type of operation, presence of hypertension or diabetes, and the techniques used to collect data (5)(6)(7)(8).…”

“…Factors that increase the risk of hypotension include patient factors (advanced age, female sex, pregnancy, obesity, diabetes mellitus, hypertension, and anemia) and technical factors such as a block level at or above T5, use of opioids during premedication, and high local anesthetic dosages (5)(6)(7)(8).…”

Propofol to facilitate spinal anesthesia in the lateral position in patients with femoral neck fracture

“…15 L'hypotension était définie par une diminution de la PAS d'au moins 30 %. 16 Aucun patient n'a atteint ce critère. Un autre avantage du propofol est son effet anti-nauséeux ainsi que son confort plus important que le midazolam pour les patients.…”

“…L'hypotension était définie par une diminution de la PAS d'au moins 30 %. 16 Les données sont présentées sous forme de moyenne ± écart-type ou de ratio. Les comparaisons entre les pressions artérielles, la FC et la SpO 2 à T0, T5, et T10, ont été réalisées à l'aide d'une ANOVA, puis le test de Mann Whitney (post hoc) a été appliqué.…”

Prophylactic glycopyrrolate reduces hypotensive responses in elderly patients during spinal anesthesia: a randomized controlled trial

“…It results from the sympathetic blockade after induction of spinal anesthesia which sequentially decreases systemic vascular resistance and cardiac output. 1 It is more common in elderly patients, with a reported incidence of 65-75%. [2][3][4] In addition, hypotension during spinal anesthesia may be combined with bradycardia-caused by the blockade of sympathetic cardiac accelerator fibers that arise at T1-T4-to prevent the development of reflex tachycardia.…”