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Predictors of early hypotension during spinal anesthesia

BACKGROUND AND OBJECTIVES: The identification of hypotension predicting factors during spinal anesthesia may interfere in the choice of the technique or call for preventive measures. This study aimed at identifying pre-anesthetic factors as independent hypotension predictors during spinal anesthesia. METHODS: Participated in this study 76 adult patients of both genders undergoing spinal anesthesia with 0.5% hyperbaric bupivacaine. The following parameters were collected: age, gender, weight, height, body mass index, systemic hypertension history, use of anti-hypertensive agents, preanesthetic medication, ankle and arm systolic and diastolic blood pressure, heart rate, pulse pressure, vascular overload, ankle-arm SBP index, bupivacaine doses, upper sensory block level and the lowest SBP measured at 2.5 minute intervals for 20 minutes. Patients were randomly allocated to receive oxygen (3 L.min-1). Hypotension was defined as systolic blood pressure below 80% of control or below 90 mmHg. Logistic regression was applied to identify independent hypotension predictors. RESULTS: The following variables were independently associated to systolic hypotension: more than 45 years of age, female gender and upper sensory level above T7. CONCLUSIONS: More than 45 years of age, female gender and upper sensory level above T7 were identified as independent predictors of early hypotension during spinal anesthesia.

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Sociedade Brasileira de Anestesiologia R. Professor Alfredo Gomes, 36, 22251-080 Botafogo RJ Brasil, Tel: +55 21 2537-8100, Fax: +55 21 2537-8188 - Campinas - SP - Brazil
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