Prospective study of hypotension and bradycardia during spinal anesthesia with bupivacaine: incidence and risk factors, part two.

摘要: Objective Hypotension and bradycardia during spinal anesthesia are common may relate to severe adverse events such as cardiac arrest or death. The authors'first retrospective study identified three non-modfiiable factors including females, age more than 40 years, type of operation. Level blockage higher T5 was the only one modifiable factor that could be confirmed That strongly limited by nature anesthetic record reviewed study. Material method authors prospectively studied records 2, 000 patients who received at Sriraj Hospital from 1 July 2004 31 December 2004. collected parameters were patient demographic data (sex, age, body weight, height, ASA status), operative (type operation, emergency status, position duration operation), dosage local agents used, intravenous fluid, vasoactive sedative agents, highest sensory level blockage, usage doses opioids). Recording forms hypotension completed responsible team in each consecutive patient. Results Incidence (20% decrease systolic blood pressure) present 57.9%. incidence cesarean section. Four non-modifiable risk which included 50, mass index 35 (OR = 2.1, 95% CI 1.01-4.29) Two high dose heavy bupivacaine 1. 88, 95%CI 3-2.74) equal 2.27, 1.73-2.97). Conclusion Usage two associated with anesthesia. Avoidance block lower can reduced severity after