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Hypotension after spinal anesthesia for cesarean section: identification of risk factors using an anesthesia information management system

Objective. To determine risk factors for developing hypotension after spinal anesthesia for cesarean section to prevent obstetric patients from hypotensive episodes potentially resulting in intrauterine malperfusion and endangering the child. Methods. The data from 503 women, having received spinal...

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Published in:Journal of clinical monitoring and computing 2009-04, Vol.23 (2), p.85-92
Main Authors: Brenck, F., Hartmann, B., Katzer, C., Obaid, R., Brüggmann, D., Benson, M., Röhrig, R., Junger, A.
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description Objective. To determine risk factors for developing hypotension after spinal anesthesia for cesarean section to prevent obstetric patients from hypotensive episodes potentially resulting in intrauterine malperfusion and endangering the child. Methods. The data from 503 women, having received spinal anesthesia for cesarean sections were investigated using online gathered vital signs and specially checked manual entries employing an anesthesia information management system. Blood pressure, heart rate, and oxygen saturation were measured throughout and hypotension was defined as either a drop in mean arterial blood pressure of >20% from baseline value or readings of
doi_str_mv 10.1007/s10877-009-9168-x
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To determine risk factors for developing hypotension after spinal anesthesia for cesarean section to prevent obstetric patients from hypotensive episodes potentially resulting in intrauterine malperfusion and endangering the child. Methods. The data from 503 women, having received spinal anesthesia for cesarean sections were investigated using online gathered vital signs and specially checked manual entries employing an anesthesia information management system. Blood pressure, heart rate, and oxygen saturation were measured throughout and hypotension was defined as either a drop in mean arterial blood pressure of &gt;20% from baseline value or readings of &lt;90 mmHg systolic arterial blood pressure. Thirty-two variables were studied for association with hypotensive episodes using univariate analysis and logistic regression employing a forward stepwise algorithm to identify independent variables ( P &lt; 0.05). Results. Hypotension was found in 284 cases (56.5%). The univariate analysis identified the neonate’s weight, mother’s age, body mass index, and peak sensory block height associated with hypotension. Body mass index, age and sensory block height were detected as independent factors for hypotension (odds-ratio: 1.61 each). Conclusions. Knowledge of these risk factors should increase the anesthesiologist’s attention to decide for the necessity to employ prophylactic or therapeutic techniques or drugs to prevent the neonate from any risk resulting of hypotension of the mother.</description><identifier>ISSN: 1387-1307</identifier><identifier>EISSN: 1573-2614</identifier><identifier>DOI: 10.1007/s10877-009-9168-x</identifier><identifier>PMID: 19277879</identifier><identifier>CODEN: JCMCFG</identifier><language>eng</language><publisher>Dordrecht: Springer Netherlands</publisher><subject>Adult ; Age Factors ; Algorithms ; Anesthesia, Spinal - adverse effects ; Anesthesiology ; Blood Pressure - physiology ; Body Mass Index ; Cesarean Section - methods ; Critical Care Medicine ; Female ; Health Sciences ; Heart Rate - physiology ; Humans ; Hypotension - chemically induced ; Hypotension - epidemiology ; Hypotension - physiopathology ; Intensive ; Logistic Models ; Management Information Systems ; Medicine ; Medicine &amp; Public Health ; Pregnancy ; Retrospective Studies ; Risk Factors ; Statistics for Life Sciences ; Young Adult</subject><ispartof>Journal of clinical monitoring and computing, 2009-04, Vol.23 (2), p.85-92</ispartof><rights>Springer Science+Business Media, LLC 2009</rights><lds50>peer_reviewed</lds50><woscitedreferencessubscribed>false</woscitedreferencessubscribed><citedby>FETCH-LOGICAL-c400t-fef2fc2793cceed51d7d7569658aa7dcb7a89783d07370a141f44524f6c467463</citedby><cites>FETCH-LOGICAL-c400t-fef2fc2793cceed51d7d7569658aa7dcb7a89783d07370a141f44524f6c467463</cites></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><link.rule.ids>314,780,784,27924,27925</link.rule.ids><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/19277879$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><creatorcontrib>Brenck, F.</creatorcontrib><creatorcontrib>Hartmann, B.</creatorcontrib><creatorcontrib>Katzer, C.</creatorcontrib><creatorcontrib>Obaid, R.</creatorcontrib><creatorcontrib>Brüggmann, D.</creatorcontrib><creatorcontrib>Benson, M.</creatorcontrib><creatorcontrib>Röhrig, R.</creatorcontrib><creatorcontrib>Junger, A.</creatorcontrib><title>Hypotension after spinal anesthesia for cesarean section: identification of risk factors using an anesthesia information management system</title><title>Journal of clinical monitoring and computing</title><addtitle>J Clin Monit Comput</addtitle><addtitle>J Clin Monit Comput</addtitle><description>Objective. To determine risk factors for developing hypotension after spinal anesthesia for cesarean section to prevent obstetric patients from hypotensive episodes potentially resulting in intrauterine malperfusion and endangering the child. Methods. The data from 503 women, having received spinal anesthesia for cesarean sections were investigated using online gathered vital signs and specially checked manual entries employing an anesthesia information management system. Blood pressure, heart rate, and oxygen saturation were measured throughout and hypotension was defined as either a drop in mean arterial blood pressure of &gt;20% from baseline value or readings of &lt;90 mmHg systolic arterial blood pressure. Thirty-two variables were studied for association with hypotensive episodes using univariate analysis and logistic regression employing a forward stepwise algorithm to identify independent variables ( P &lt; 0.05). Results. Hypotension was found in 284 cases (56.5%). 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To determine risk factors for developing hypotension after spinal anesthesia for cesarean section to prevent obstetric patients from hypotensive episodes potentially resulting in intrauterine malperfusion and endangering the child. Methods. The data from 503 women, having received spinal anesthesia for cesarean sections were investigated using online gathered vital signs and specially checked manual entries employing an anesthesia information management system. Blood pressure, heart rate, and oxygen saturation were measured throughout and hypotension was defined as either a drop in mean arterial blood pressure of &gt;20% from baseline value or readings of &lt;90 mmHg systolic arterial blood pressure. Thirty-two variables were studied for association with hypotensive episodes using univariate analysis and logistic regression employing a forward stepwise algorithm to identify independent variables ( P &lt; 0.05). Results. Hypotension was found in 284 cases (56.5%). The univariate analysis identified the neonate’s weight, mother’s age, body mass index, and peak sensory block height associated with hypotension. Body mass index, age and sensory block height were detected as independent factors for hypotension (odds-ratio: 1.61 each). Conclusions. Knowledge of these risk factors should increase the anesthesiologist’s attention to decide for the necessity to employ prophylactic or therapeutic techniques or drugs to prevent the neonate from any risk resulting of hypotension of the mother.</abstract><cop>Dordrecht</cop><pub>Springer Netherlands</pub><pmid>19277879</pmid><doi>10.1007/s10877-009-9168-x</doi><tpages>8</tpages></addata></record>
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ispartof Journal of clinical monitoring and computing, 2009-04, Vol.23 (2), p.85-92
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1573-2614
language eng
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source Springer Nature
subjects Adult
Age Factors
Algorithms
Anesthesia, Spinal - adverse effects
Anesthesiology
Blood Pressure - physiology
Body Mass Index
Cesarean Section - methods
Critical Care Medicine
Female
Health Sciences
Heart Rate - physiology
Humans
Hypotension - chemically induced
Hypotension - epidemiology
Hypotension - physiopathology
Intensive
Logistic Models
Management Information Systems
Medicine
Medicine & Public Health
Pregnancy
Retrospective Studies
Risk Factors
Statistics for Life Sciences
Young Adult
title Hypotension after spinal anesthesia for cesarean section: identification of risk factors using an anesthesia information management system
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