Key result
Controlled hypertension linked to a ~3-fold higher incidence of hypotension under spinal anesthesia versus normotension.
Why the study?
The occurrence of hypotension under spinal anesthesia among controlled hypertensive and normotensive patients aged 40 years and above is still debated.
Do patients with controlled hypertension have a higher incidence of hypotension and bradycardia following spinal anesthesia compared to normotensive patients?
Cohort (n=110)
No
Do patients with controlled hypertension have a higher incidence of hypotension and bradycardia following spinal anesthesia compared to normotensive patients?
Absolute Event Rate: 23.6% vs 7.3%
p-value: p=0.018
Patients with controlled hypertension are at a higher risk of developing hypotension following spinal anesthesia compared to normotensive patients, highlighting the need for careful hemodynamic monitoring in this population.
Background. Hypotension and bradycardia are the most common complications associated with spinal anesthesia and more common in patients with a history of hypertension. Regular use of antihypertensive medications can prevent these complications. The occurrence of hypotension under spinal anesthesia among controlled hypertensive and normotensive patients with age 40 years and above is still debated. The objective of the study was to compare blood pressure and heart rate changes following spinal anesthesia between controlled hypertensive and normotensive patients undergoing surgery below the umbilicus at Black lion hospital, Addis Ababa, Ethiopia, 2020. Method. A hospital-based prospective cohort study was conducted. A total of 110 elective patients with controlled hypertension (55) and normotensive (55) patients who underwent surgery with spinal anesthesia at black lion hospital during the study period were included. The sample was selected using a systematic random sampling technique. Continuous data of independent and dependent variables were analyzed using an independent sample t-test for normally distributed and Mann–Whitney U-test for nonnormally distributed between the study groups. Categorical variables between the study groups were analyzed using the chi-square test. Descriptive data were displayed using tables and figures. For continuous and categorical variables, a p value <0.05 was considered statistically significant. Results. The incidence of hypotension in the controlled hypertension group (23.6%) was higher than the normotensive group (7.3%) with p value of 0.018. The occurrence of bradycardia was seen to be 12.7% in each group with a p value >0.05. There was a statistically significant difference in the mean systolic blood pressure, mean arterial pressure, mean heart rate, and vasopressor consumption at the measurement time interval between controlled hypertension and normotensive groups. Conclusion. Under spinal anesthesia, patients with controlled hypertension are more likely to develop hypotension than normotensive patients, but on the occurrence of bradycardia, there was no statistically significant difference between the two groups.
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Gebrargs et al. (2021) conducted a cohort in Patients undergoing surgery below the umbilicus under spinal anesthesia (n=110). Controlled hypertension vs. Normotension was evaluated on Incidence of hypotension (p=0.018). Under spinal anesthesia, patients with controlled hypertension had a significantly higher incidence of hypotension compared to normotensive patients (23.6% vs 7.3%, P=0.018).
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