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

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