VARIATION IN THE SYSTOLIC ARTERIAL PRESSURE WITH THE CHANGES OF POSITION, AS PREDICTOR OF POSTANESTHETIC HYPOTENSION IN ELECTIVE CESAREAN (IN SPANISH)

• Main Authors: De la Peña-Martínez Michael, Granados-Vergara Lina María, Polo-Mendoza Eduy, De la Peña-Martínez Jairo4
• Format: Article
• Language: Spanish
• Published: Universidad de Cartagena 2014-01-01
• Series: Revista Ciencias Biomédicas
• Subjects: Arterial Pressure; Blood Pressure; Cesarean Section; Anesthesia
• Online Access: http://revistacienciasbiomedicas.com/index.php/revciencbiomed/article/view/319/256
• ISSN: 2215-7840; 2215-7840

Introduction: It is important to identify to those pregnant women with risk to present postanesthetic arterial hypotension, when they are submitted to cesarean under spinal anesthesia. Objective: to identify if the variability in the systolic arterial pressure (SAP) with the preoperative changes of position is predictor of postanesthetic arterial hypotension in elective cesarean. Methods: 244 women with pregnancy at term, programmed for elective cesarean were studied. Preanesthetic measures of the SAP in supine decubitus and in left lateral decubitus position were carried out, estimating the difference between the two measures. Postanesthetic arterial hypotension was defined as SAP lower than 90 mmHg or reduction higher to 30% of the SAP in supine decubitus position. Results: postanesthetic arterial hypotension was presented in 107 (43.8%) of the pregnant women. The variation of the SAP in the group that presented postanesthetic arterial hypotension was 10.5 [2.0 to 16.5] Vs 2.5 [-6.5 to 6.0] between those who did not present it (P<0,0001). It was estimated that variability higher to 11 mmHg of the SAP predicted postanesthetic arterial hypotension with sensibility: 47.6%, specificity: 93.4%, LR (+): 7.26, LR (-): 0.58 and area under the curve of 0.737 (CI 95%: 0.677-0.791), (p=0.0001). In turn such a variation was significant risk factor for the decrease of the arterial pressure. RR: 2.79 (CI95%: 2.19-3.56). Conclusion: the preanesthetic variation of the SAP with the change of position from supine decubitus to lateral decubitus position was predictor of arterial hypotension subsequent to the use of spinal anesthesia in pregnant women submitted to elective cesareans. Rev.Cienc.Biomed. 2014;5(1):29-34 KEYWORDS Arterial Pressure; Blood Pressure; Cesarean Section; Anesthesia, Obstetric.