Incidence and Associated Factors of Hypotension After Spinal Anesthesia Who Undergo Both Elective and Emergency Surgery Under Spinal Anesthesia at Tikur Anbesa Specialized Hospital.
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Date
2024-05
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Addis Ababa University
Abstract
Background: Hypotension is one of the feared complications associated with spinal
anesthesia. Though data is scarce in low-income countries, the incidence of post spinal
hypotension ranges from 15-33%. Different factors are associated with the development of
post spinal hypotension like patient related factors, anesthesia related factors and surgical
related factors thus identifying the incident and associated factors of post spinal
hypotension will help identify preventive measures.
Objective: To assess the incidence and associated factors of post spinal anesthesia
hypotension on patients undergoing surgery at Tikur Anbesa specialized hospital, from
November 1, 2023-Fev 30, 2024GC.
Method: Hospital based cross sectional study was conducted using 258 patients. A
structured pre-tested modified and adopted questionnaire was used to collect data who
underwent surgery using spinal anesthesia at Tikur Anbesa specialized hospital, from
November 1, 2023-Fev 30, 2024GC. A proportional stratiefied random sampling was
used to select study subjects. Data was entered cleared using Epi data version 3.1 then
exported to SPSS version 27 for analysis.Odd ratio was calculated on variables to
determine associated through binary and multivariate logistic regression.
Result: Among 258 patients who underwent surgery incident of post spinal hypotension
was 15.5%, using at 5% level of significant multivariable binary logistic regression;
hypertension, sensory block above T5 and hemoglobin level <10mg/dl were associated
with development of post spinal hypotension. The odd ratio of developing post spinal
hypotension in hypertensive patient was 3.47 times AOR = 3.474, 95%CI= [1.356–8.897]
than patients who has no hypertension. The odd ratio of developing post spinal
hypotension in patients’ hemoglobin <10mg/dl was 2.85 times AOR =2.85, 95% CI=
[1.113-7.299] than patients’ hemoglobin >10mg/dl, sensory block above increase post
spinal hypotension by 5 times T5, AOR = 5.196, 95% CI = [2,286 – 13.331]. But there
was no association with age,baricity,baseline heart rate,chronic alcohol
consumption,urgency of surgery.
Conclusion: This study revealed that the incidence of spinal anesthesia induced
hypotension was relatively low, and the independent associated factors were history of
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hypertension, hemoglobin level less than 10mg/dl and sensory block above T5. The mean
time to develop post spinal hypotension was 14 minutes.
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Keywords
Post Spinal Anesthesia hypotension, Baricite