Changes in the corrected carotid flow time can predict spinal anesthesia-induced hypotension in patients undergoing cesarean delivery: an observational study

• Published in: Journal of anesthesia 2024-02, Vol.38 (1), p.105-113
• Main Authors: Juri, Takashi, Suehiro, Koichi, Yasuda, Shinta, Kimura, Aya, Fujimoto, Yohei, Mori, Takashi
• Format: Article
• Language: English
• Subjects: Anesthesia, Obstetrical - adverse effects; Anesthesia, Spinal - methods; Anesthesiology; Critical Care Medicine; Emergency Medicine; Female; Humans; Hypotension - etiology; Hypotension, Controlled; Intensive; Medicine; Medicine & Public Health; Original Article; Pain Medicine; Patient Positioning - adverse effects; Pregnancy
• ISSN: 0913-8668; 1438-8359; 1438-8359
• DOI: 10.1007/s00540-023-03293-2

Purpose Spinal anesthesia is a standard technique for cesarean delivery; however, it possesses a risk of hypotension. We hypothesised that the changes in the corrected flow time induced by the Trendelenburg position could predict the incidence of hypotension after spinal anesthesia for cesarean delivery. Methods Patients undergoing elective cesarean delivery under spinal anesthesia were enrolled. Before anesthesia induction, corrected flow time was measured in the supine and Trendelenburg positions (FTc-1 and FTc-2, respectively). Additionally, a percent change in corrected flow time induced by the Trendelenburg position was defined as ΔFTc. The primary endpoint was to investigate the ability of ΔFTc to predict the incidence of spinal anesthesia-induced hypotension until delivery. The receiver operating characteristics curves to assess the ability of FTc-1, FTc-2, and ΔFTc to predict the incidence of hypotension were generated. Results Finally, 40 patients were included, and of those, 26 (65%) developed spinal anesthesia-induced hypotension. The areas under the curve for FTc-1, FTc-2, and ΔFTc were 0.591 (95% CI: 0.424 to 0.743) (P = 0.380), 0.742 (95% CI: 0.579 to 0.867) (P = 0.004), and 0.882 (95% CI: 0.740 to 0.962) (P