Incidence and Associated factors for Hypotension after Spinal Anestheaia during Cesarean section at Gandhi memorial hospital Addis Abeba,Ethiopia,May2019.
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Date
2019-05
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Addis Abeba University
Abstract
Introduction: Spinal anesthesia is a type of regional anesthesia, has been practiced for
obstetric anaesthesia since the beginning of the 20
th
century.so it is easy to perform and
reliable as well avoids the depressant effects of anesthetic drugs and has a potential to
provide excellent operating conditions for caesarean section. Hypotension is a usual
consequence of sympathetic motor and sensory block caused by spinal anesthesia for
cesarean section.
Objectives: The objective of the study is to determine the incidence and associated factors
for hypotension after spinal anesthesia during cesarean section at Gandhi memorial hospital,
Addis Ababa, Ethiopia.
Method: Institutional based cross sectional study was conducted on 422 clients using
structured questionnaire until the end of the operation. The study was conducted on cesarean
section under spinal anesthesia from January, to April 30, 2019 at Gandhi memorial Hospital,
Addis Ababa, Ethiopia. Systematic random sampling technique was used for selecting the
sample. Both bivariate and multivariate logistic regression analysis were done for associated
factors. Level of statistical significance was declared at p-value less than 0.05.
Results: The incidence of hypotension among mothers who undergone cesarean section after
spinal anesthesia was 64%. Neonate weight of 2.5-3.9kg AOR=3.440; 95% CI:( 1.441-8.211)
and greater than 4kg AOR=4.957; 95%CI: (1.563-15.722) showed increased association with
hypotension. A baseline systolic blood pressure less than 120mmHg AOR= 5.527; 95%CI:
(2.695-11.336), and in the range of 120-130mmHg AOR=3.583; 95%CI: (1.980-6.485) was
associated with hypotension. Sensory block height >T6 AOR= 2.272; 95%CI: (1.362-3.788)
and the time interval between spinal induction and skin incision > 6minutes
AOR=1.758;95%CI: (1.022-3.024) are also associated with hypotension after spinal
anesthesia.
Conclusion: The risk of hypotension is high in cesarean section after spinal anesthesia. The
identified risk factors for spinal anesthesia induced hypotension are sensory height block,
weight of the baby, time interval between spinal induction and skin incision, the baseline
systolic blood pressure and experience of anesthetist.
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Keywords
Hypotension, spinal anesthesia, cesarean section, Addis Ababa, Ethiopia