Incidence and risk factors of hypotension and bradycardia after spinal anesthesia for cesarean section.

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dc.contributor.authorSomboonviboon, Wannaen_US
dc.contributor.authorKyokong, Oranuchen_US
dc.contributor.authorCharuluxananan, Somraten_US
dc.contributor.authorNarasethakamol, Arunchaien_US
dc.date.accessioned2009-05-27T20:45:49Z
dc.date.available2009-05-27T20:45:49Z
dc.date.issued2008-02-09en_US
dc.descriptionChotmaihet Thangphaet.en_US
dc.description.abstractBACKGROUND: Hypotension or bradycardia after spinal anesthesia for cesarean section remain common and are serious complications. The current study evaluated factors associated to the incidences of hypotension or bradycardia in this context. MATERIAL AND METHOD: A prospective cross sectional study from November 1, 2004 to July 31, 2005 was conducted on 722 parturients undergoing cesarean section under spinal anesthesia. T-test and Chi-square test were used in univariate analysis to compare continuous data and categorical data respectively. Multivariate logistic regression was performed on the variables hypotension (systolic pressure decrease > 30% of baseline value) and bradycardia (heart rate < 60 bpm) p-value < 0.05 was considered significant. RESULTS: Incidence of hypotension and bradycardia were 52.6% and 2.5%. The probability of hypotension increased with estimated blood loss 500-1000 mL (odds ratio [OR] = 1.86; 95% CI 1.30-2.67, p = 0.001), estimated blood loss > 1000 mL (OR = 5.31; 95% CI 1.47-19.19, p = 0.011), and analgesia level > T4 (OR = 1.94; 95% CI 1.18-3.19, p = 0.009). Hypotension occurred despite left uterine displacement (OR = 1.56; 95% CI 1.11-2.19, p = 0.01). Risk factors associated with bradycardia were adding intrathecal morphine 0.2 mg (0.2 mL) (OR = 4.61; 95% CI 1.31-16.19, p = 0.017) to local anesthetics. CONCLUSION: The present results indicated that the incidence of hypotension after spinal anesthesia for cesarean section increased with amount of estimated blood loss > 500 mL and analgesic level > T4. Adding intrathecal morphine 0.2 mg (0.2 mL) to local anesthetics increased incidence of bradycardia.en_US
dc.description.affiliationDepartment of Anesthesiology, Faculty of Medicine, Chulalongkorn University Bangkok, Thailand.en_US
dc.identifier.citationSomboonviboon W, Kyokong O, Charuluxananan S, Narasethakamol A. Incidence and risk factors of hypotension and bradycardia after spinal anesthesia for cesarean section. Journal of the Medical Association of Thailand. 2008 Feb; 91(2): 181-7en_US
dc.identifier.urihttps://imsear.searo.who.int/handle/123456789/43590
dc.language.isoengen_US
dc.source.urihttps://www.mat.or.th/journal/all.phpen_US
dc.subject.meshAdulten_US
dc.subject.meshAnesthesia, Local --adverse effectsen_US
dc.subject.meshAnesthesia, Spinal --adverse effectsen_US
dc.subject.meshBradycardia --chemically induceden_US
dc.subject.meshCesarean Sectionen_US
dc.subject.meshCross-Sectional Studiesen_US
dc.subject.meshFemaleen_US
dc.subject.meshHumansen_US
dc.subject.meshHypotension --chemically induceden_US
dc.subject.meshIncidenceen_US
dc.subject.meshInjections, Spinalen_US
dc.subject.meshLogistic Modelsen_US
dc.subject.meshMorphine --administration & dosageen_US
dc.subject.meshPerioperative Careen_US
dc.subject.meshPostoperative Perioden_US
dc.subject.meshPregnancyen_US
dc.subject.meshProspective Studiesen_US
dc.subject.meshRisk Factorsen_US
dc.titleIncidence and risk factors of hypotension and bradycardia after spinal anesthesia for cesarean section.en_US
dc.typeJournal Articleen_US
dc.typeResearch Support, Non-U.S. Gov'ten_US
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