The incidence and associated factors of hypotension during spinal anesthesia at tertiary hospital: a prospective cross-sectional study

Background: Spinal anesthesia is currently the most commonly used technique for procedures below the umbilicus, although it is safe. However, the most common complication associated with this technique is the onset of hypotension after administration of spinal anesthesia. Method: This institution-based, cross-sectional study included 402 patients. The study was conducted on patients who underwent surgery under spinal anesthesia from 30 June 2023-30 November 2024, to tertiary, in central Ethiopia, Hossana, Ethiopia. Study participants were selected using a systematic random sampling technique. A pre-tested structured questionnaire was used to collect the data. The data were entered into EpiData (version 4.6) and exported to SPSS (version 26.0). Binary logistic regression was used to identify the factors independently associated with spinal-induced hypotension. The level of statistical significance was set at P <0.05. Results: The incidence of hypotension was 46%. There are two modifiable risk factors, namely, sensory block level> T5 and prolonged duration of surgery, and three non-modifiable risk factors, namely age, emergency surgery, and American Society of Anesthesiology (ASA) status. Age ranging from 20 to 39 years (adjusted odds ratio(AOR): 8.531; 95% confidence interval(CI]: (1.881–38.695)), age ranging from 40 to 59 years (AOR: 13.512; 95% CI: (4.845–37.684)), age > 60 years (AOR: 12.49; 95% CI: (4.697–33.210)), duration of surgery > 2 h (AOR: 2.771; 95% CI: 1.521–5.05), sensory block level> T5 (AOR: 1.838; 95% CI: (1.068–3.163)), ASA status (AOR: 2.131; 95% CI: 1.093–4.155)) and emergency surgery (AOR: 7.075; 95% CI: 1.768–28.306)) were associated with hypotension. Conclusion: We found that age, sensory block level, ASA status > II, emergency surgery, and prolonged duration of surgery were independently associated with hypotension.