Prediction of hypotension during spinal anesthesia for elective cesarean section by altered heart rate variability induced by postural change

Sakata, Koji; Yoshimura, Noritaka; Tanabe, Kumiko; Kito, Kazuhiro; Nagase, Kenji; Iida, Hiroki

doi:10.1016/j.ijoa.2016.09.004

Cited by 30 publications

(17 citation statements)

References 23 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…Heart rate variability analysis captures the autonomic nervous activity and has been shown to predict spinal anesthesia induced hypotension in pregnant women 17 , 18 , and the ratio of the low frequency and the high frequency bands (LF/HF) correlated with spinal induced hypotension. Spinal anesthesia induced hypotension is caused by the vasodilatory effects, and to a lesser extent by aorto-caval compression 5 , and the relationship between estimated autonomic activity (LF/HF) and spinal anesthesia induced hypotension is likely.…”

Section: Discussionmentioning

confidence: 99%

“…The requirements of heart rate variability analyses limits the feasibility as stable ECG-signals has to be monitored at least 5 minutes to perform the frequency domain analyses 19 . Sakata et al, analyzed heart rate variability during postural changes and found a correlation between low-to-high frequency ratio shift and spinal induced hypotension during cesarean delivery 18 . Time domain analyses or continuous wavelet transform may be applicable 20 and requires shorter heart rate recordings.…”

Section: Discussionmentioning

confidence: 99%

See 1 more Smart Citation

A three minutes supine position test reveals higher risk of spinal anesthesia induced hypotension during cesarean delivery. An observational study.

2018

View full text Add to dashboard Cite

Background: Cesarean delivery is performed under spinal anesthesia, and vasodilation is the main cause for a drop in blood pressure. The compression of the aorta and inferior vena cava by the gravid uterus is of additional clinical importance. Hypotension may occur during cesarean delivery even if prophylactic infusion of phenylephrine is practiced. We have tested if a 3 minute supine observation, can identify a subset of women with decreasing systolic arterial pressure (SAP) under spinal anesthesia. Methods: We performed a prospective observational study at Oslo University Hospital on healthy pregnant women for planned cesarean delivery. Continuous measurements of calibrated invasive SAP and estimated cardiac output were recorded for 76 women in a 3 minutes measurement with the woman in the left lateral position, followed by supine position for 3 minutes. Using functional data clustering, principal component analysis and curve smoothing, to filter way noise and reduce the dimensionality of the signal, we clustered the women into separate SAP groups. Results: We identified two significantly different groups of women during supine position; one characterized by initial drop in SAP, the other showed initial increase. After spinal anesthesia, the mean SAP curve of the women in the first group showed a drop in blood pressure, which was more rapid than for the other women. A minor difference in cardiac output was observed between the two groups of women with the mean cardiac output curve for the first group being higher. Conclusions: This work indicates that supine position affect clinically relevant cardiovascular measurements in pregnant women. A simple test may identify patients with increased risk of spinal anesthesia induced hypotension.

show abstract

Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

A three minutes supine position test reveals higher risk of spinal anesthesia induced hypotension during cesarean delivery. An observational study.

2018

View full text Add to dashboard Cite

show abstract

“…Eleven other studies did not confirm this relationship. 5,11,13,14,16,19,21,28,[36][37][38] Baseline maternal blood pressure was also assessed in 11 studies with 1281 patients. Fakherpour et al 31 reported a strong relationship between baseline systolic blood pressure (SBP) and spinal anesthesia-induced hypotension (relative RR 6.53).…”

Section: Domain II Baseline Hemodynamic Parametersmentioning

confidence: 99%

Prediction of spinal anesthesia-induced hypotension during elective cesarean section: a systematic review of prospective observational studies

Chen

Liao

et al. 2021

International Journal of Obstetric Anesthesia

View full text Add to dashboard Cite

This is a PDF file of an article that has undergone enhancements after acceptance, such as the addition of a cover page and metadata, and formatting for readability, but it is not yet the definitive version of record. This version will undergo additional copyediting, typesetting and review before it is published in its final form, but we are providing this version to give early visibility of the article. Please note that, during the production process, errors may be discovered which could affect the content, and all legal disclaimers that apply to the journal pertain.

show abstract

“…However, administration of prophylactic vasopressor agents in pregnant women may cause undesirable effects on the mother and fetus. Therefore, studies have been carried out with noninvasive methods, such as thoracic electrical bioimpedance, measurement of heart rate variability, cerebral near-infrared spectroscopy, point-of-care ultrasound, perfusion index (PI), and Pleth variability index (PVI) to predict which parturient would develop hypotension (4)(5)(6)(7)(8)(9)(10)(11)(12)(13)(14) .…”

Section: Introductionmentioning

confidence: 99%

Can Perfusion Index or Pleth Variability Index Predict Spinal Anesthesia Induced Hypotension During Caesarean Section?

Arslan¹,

Öksüz²,

Bilal³

et al. 2019

JARSS

View full text Add to dashboard Cite

Objective: Although spinal anesthesia is the preferred anesthetic method for cesarean sections, it leads to hypotension in a significant proportion of the patients. In this study, we assessed the predictive ability of perfusion index (PI) and Pleth variability index (PVI) in different positions, for prediction of hypotension after spinal anesthesia administered for cesarean delivery. Methods: Ninety parturients scheduled for elective lower segment cesarean section under spinal anesthesia were enrolled in the study. In the preoperative holding area, PI and PVI values were recorded in the supine, semi-recumbent, passive leg raise and left lateral positions. Then, parturients were taken to the operating room; their PI and PVI values were recorded again in the supine and sitting positions. Spinal anesthesia was performed with 0.5% hyperbaric bupivacaine (10 mg) injected through L3-L4 or L4-L5 interspaces with the patient in the sitting position. PI and PVI values were recorded one minute after induction of spinal anesthesia as postspinal measurements. The effects of independent variables on hypotension were examined with logistic regression analysis. The relationship between PI and PVI values and incidence of hypotension was evaluated using ROC analysis. Results: The incidence of hypotension was 60 percent. Postspinal PVI was found to have a weak predictive value for postspinal hypotension (AUC=0.663, 95% CI 0.530-0.796, p=0.024). Conclusion: Among the parameters evaluated, only postspinal PVI was associated with spinal anesthesia-induced hypotension in cesarean section. However, it may not be useful in routine clinical practice due to its low specificity and sensitivity.

show abstract

Prediction of hypotension during spinal anesthesia for elective cesarean section by altered heart rate variability induced by postural change

Cited by 30 publications

References 23 publications

A three minutes supine position test reveals higher risk of spinal anesthesia induced hypotension during cesarean delivery. An observational study.

A three minutes supine position test reveals higher risk of spinal anesthesia induced hypotension during cesarean delivery. An observational study.

Prediction of spinal anesthesia-induced hypotension during elective cesarean section: a systematic review of prospective observational studies

Can Perfusion Index or Pleth Variability Index Predict Spinal Anesthesia Induced Hypotension During Caesarean Section?

Contact Info

Product

Resources

About