Magnitude of Hemodynamic and Airway Pressure Change and Factors Associated with Intraoperative Hypotension During Elective Neurosurgery
No Thumbnail Available
Date
2017-06
Authors
Journal Title
Journal ISSN
Volume Title
Publisher
Addis Abeba University
Abstract
Background: Neurosurgery is a medical specialty which is concerned with the prevention,
diagnosis, treatment and rehabilitation of disorders that affect the entire nervous system.
Hemodynamic change is one of the complications of neurosurgery with an incidence differing with
multiple factors. Positioning during neurosurgery has an impact on airway pressure. Poor anesthetic
management during neurosurgery will lead to permanent injuries to the patient, which otherwise are
largely preventable.
Objective: The aim of this study is to assess magnitude of hemodynamic and airway pressure
change and factors associated with intraoperative hypotension during elective neurosurgery in
Tikur Anbessa specialized hospital and Empress Zewditu memorial hospital, 2017
Method: Institutional based cross sectional study was used from December 20, 2016 to May 20,
2017 using pre-tested, interviewer administered questionnaire for 208 patients. Due to rarity of
the procedure all eligible patients who underwent elective neurosurgery at Tikur Anbessa
Specialized hospital and Empress Zewditu memorial hospital during the data collection period
were included in the study. The data was entered to Epi Info version 7.2.1 and analyzed by SPSS
version 20 software performing descriptive statistics, bivariate and multivariate logistic
regression.
Result: The magnitude of intraoperative hypotension is found to 29.3% (95% CI: 22%-35%).
Intraoperative Hypertension had magnitude of 1% (95%CI: 0.0%-2.4%) with bradycardia and
tachycardia having 2.4% (95%CI: 0.5%-4.8%) and 1% (95%CI: 0.0%-2.9%) respectively. Blood
loss of >10ml/Kg has >5 times [AOR=5.77; 95% CI: (1.97, 16.83)] more risk for developing
intraoperative hypotension and Phenytoin use [AOR=6.96; 95% CI: (1.97, 24.50)] had
significant association with intraoperative hypotension.
Conclusion and recommendation: The magnitude of intraoperative hypotension is high. Some
of the identified factors were Blood loss of >10ml/Kg and Phenytoin use. Therefore early
anticipation and preparation of intraoperative hypotension in patients especially taking phenytoin
and risk of increased blood loss can improve patient outcome.
Description
Keywords
Hemodynamic; Airway Pressure