Abstract:
Abstract
Introduction: Spinal anesthesia is a common regional anesthesia technique routinely practiced
for surgical procedures below umbilicus. The term hemodynamics is the basic measures of
cardiovascular function, such as arterial blood pressure, heart rate, and cardiac output.
Hypotension and bradycardia are the most common complication associated with spinal
anesthesia and the incidence varies from 8 to 54% and 0.05-13% respectively. And these cause
major morbidity in 3% to 16%, and mortality in 0.4% to 8% of surgical patients. But the
occurrence between the two groups is still debated and there are contradicting results.
Objective: To compare hemodynamic response following spinal anesthesia between controlled
hypertensive and normotensive patients undergoing general surgery.
Method: Hospital- based Prospective cohort study design was conducted. A total of 170 elective
patients with controlled hypertensive (85) and normotensive (85) who undergone general
surgeries under spinal anesthesia in Northwest Amhara region comprehensive specialized
hospitals were included. A simple random sampling technique was used to select the sample.
Continuous data were analyzed using an independent sample t test for normally distributed and
Mann-Whitney U test for non-normally distributed. Categorical variables were analyzed using
the chi-square test. All P- values < 0.05 were considered to be statistically significant.
Result: The incidence of hypotension was 35.3% in the controlled hypertensive and 14.1% in the
normotensive group. The incidence of bradycardia was 14.1% in controlled hypertensive and
10.6% in normotensive groups. There was a statistical significant difference in the mean systolic
blood pressure, mean diastolic blood pressure, mean arterial pressure, incidence of hypotension
and vasopressor consumption at the measurement time interval between the two groups.
Conclusion and recommendation: Under spinal anesthesia patients with controlled
hypertension are more likely to develop hypotension than normotensive patients but on the
occurrence of bradycardia there was no statistical significant difference between the two groups.
Vasopressor consumption is higher in controlled hypertensive than the normotensive group.
Therefore anesthetists should anticipate and be adequately prepared for management of
hypotension
