Comparison of hemodynamic response following spinal anesthesia between controlled hypertension and normotensive patients undergoing surgery below the umbilicus at Black lion hospital, Addis Ababa, Ethiopia, 2020.
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Date
2020-06
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Addis Abeba University
Abstract
Background: Hypotension and bradycardia is the most common complication associated with
spinal anesthesia and more common in patients with history hypertension. Regular use of antihypertensive
medication can prevent this complication. The occurrence of hypotension under
spinal anesthesia among controlled hypertension and normotensive patients with age 40 years
and above is still debated.
Objective: To compare hemodynamic response following spinal anesthesia between controlled
hypertension and normotensive patients undergoing surgery below the umbilicus at Black lion
hospital, Addis Ababa, Ethiopia, 2020.
Method: hospital- based Prospective cohort study design was conducted. A total of 110 elective
patients with controlled hypertension (55) and normotensive (55) patients below the umbilical
surgery under spinal anesthesia at black the lion hospital during the study period. The Sample
was selected using a systematic 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 non-normally 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 to be statistically significant.
Results: A total of 110 patients were participated in this study. The incidence of hypotension in
the controlled hypertension group (23.6%) was higher than the normotensive group (7.3%) with
p-value 0.018. The occurrence of bradycardia was seen 12.7% in each groups with p-value >
0.05. There was a statistical 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 statistical significant difference between the two groups. Vasopressor consumption is higher
in controlled hypertension than the normotensive group.
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Keywords
Spinal anesthesia, controlled hypertension, normotensive, hypotension, bradycardia