Cargando…

Level of sensory block after spinal anesthesia as a predictor of hypotension in parturient

When the sensory block level (SBL) is ≥T5 or T4, a high incidence of hypotension occurs in parturients after spinal anesthesia. A rapidly ascending SBL is another risk factor for spinal anesthesia-induced hypotension. However, the relationship between the ascension rate of the SBL and spinal anesthe...

Descripción completa

Detalles Bibliográficos
Autores principales: Zhang, Ning, He, Liangliang, Ni, Jia-Xiang
Formato: Online Artículo Texto
Lenguaje:English
Publicado: Wolters Kluwer Health 2017
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5484208/
https://www.ncbi.nlm.nih.gov/pubmed/28640100
http://dx.doi.org/10.1097/MD.0000000000007184
_version_ 1783245837291225088
author Zhang, Ning
He, Liangliang
Ni, Jia-Xiang
author_facet Zhang, Ning
He, Liangliang
Ni, Jia-Xiang
author_sort Zhang, Ning
collection PubMed
description When the sensory block level (SBL) is ≥T5 or T4, a high incidence of hypotension occurs in parturients after spinal anesthesia. A rapidly ascending SBL is another risk factor for spinal anesthesia-induced hypotension. However, the relationship between the ascension rate of the SBL and spinal anesthesia-induced hypotension remains unclear. After placement in the left lateral position, combined epidural–spinal anesthesia was performed on 140 parturients undergoing caesarean section using the following procedure: no volume preloading, injection site of L3–4 or L4–5, injection rate of 0.1 mL/sec, and administration of 10 mg of 0.5% hyperbaric bupivacaine. A receiver-operating characteristic curve was built to estimate the accuracy of the SBL ascension rate in detecting spinal anesthesia-induced hypotension. The mean time interval from spinal injection to placement in the supine position was 136 ± 10 seconds in all anesthesia procedures. The earliest and most complete records of the SBL started from the 3rd minute after spinal injection. The threshold spread rate corresponding to the highest accuracy for occurrence of hypotension was an SBL of ≥T8 at the 3rd minute after spinal injection, with 82% and 88% sensitivity and specificity, respectively. The ascension rate of an SBL of ≥T8 at the 3rd minute after spinal injection is as a predictor of hypotension in parturients.
format Online
Article
Text
id pubmed-5484208
institution National Center for Biotechnology Information
language English
publishDate 2017
publisher Wolters Kluwer Health
record_format MEDLINE/PubMed
spelling pubmed-54842082017-07-06 Level of sensory block after spinal anesthesia as a predictor of hypotension in parturient Zhang, Ning He, Liangliang Ni, Jia-Xiang Medicine (Baltimore) 3300 When the sensory block level (SBL) is ≥T5 or T4, a high incidence of hypotension occurs in parturients after spinal anesthesia. A rapidly ascending SBL is another risk factor for spinal anesthesia-induced hypotension. However, the relationship between the ascension rate of the SBL and spinal anesthesia-induced hypotension remains unclear. After placement in the left lateral position, combined epidural–spinal anesthesia was performed on 140 parturients undergoing caesarean section using the following procedure: no volume preloading, injection site of L3–4 or L4–5, injection rate of 0.1 mL/sec, and administration of 10 mg of 0.5% hyperbaric bupivacaine. A receiver-operating characteristic curve was built to estimate the accuracy of the SBL ascension rate in detecting spinal anesthesia-induced hypotension. The mean time interval from spinal injection to placement in the supine position was 136 ± 10 seconds in all anesthesia procedures. The earliest and most complete records of the SBL started from the 3rd minute after spinal injection. The threshold spread rate corresponding to the highest accuracy for occurrence of hypotension was an SBL of ≥T8 at the 3rd minute after spinal injection, with 82% and 88% sensitivity and specificity, respectively. The ascension rate of an SBL of ≥T8 at the 3rd minute after spinal injection is as a predictor of hypotension in parturients. Wolters Kluwer Health 2017-06-23 /pmc/articles/PMC5484208/ /pubmed/28640100 http://dx.doi.org/10.1097/MD.0000000000007184 Text en Copyright © 2017 the Author(s). Published by Wolters Kluwer Health, Inc. http://creativecommons.org/licenses/by-nd/4.0 This is an open access article distributed under the Creative Commons Attribution-NoDerivatives License 4.0, which allows for redistribution, commercial and non-commercial, as long as it is passed along unchanged and in whole, with credit to the author. http://creativecommons.org/licenses/by-nd/4.0
spellingShingle 3300
Zhang, Ning
He, Liangliang
Ni, Jia-Xiang
Level of sensory block after spinal anesthesia as a predictor of hypotension in parturient
title Level of sensory block after spinal anesthesia as a predictor of hypotension in parturient
title_full Level of sensory block after spinal anesthesia as a predictor of hypotension in parturient
title_fullStr Level of sensory block after spinal anesthesia as a predictor of hypotension in parturient
title_full_unstemmed Level of sensory block after spinal anesthesia as a predictor of hypotension in parturient
title_short Level of sensory block after spinal anesthesia as a predictor of hypotension in parturient
title_sort level of sensory block after spinal anesthesia as a predictor of hypotension in parturient
topic 3300
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5484208/
https://www.ncbi.nlm.nih.gov/pubmed/28640100
http://dx.doi.org/10.1097/MD.0000000000007184
work_keys_str_mv AT zhangning levelofsensoryblockafterspinalanesthesiaasapredictorofhypotensioninparturient
AT heliangliang levelofsensoryblockafterspinalanesthesiaasapredictorofhypotensioninparturient
AT nijiaxiang levelofsensoryblockafterspinalanesthesiaasapredictorofhypotensioninparturient