Sun Shen, Liu Nai-He, Huang Shao-Qiang
Department of Anesthesiology, Obstetrics and Gynecology Hospital of Fudan University, Shanghai, China.
Department of Anesthesiology, The First People's Hospital of Lianyungang, Lianyungang, Jiangsu Province, China.
J Clin Monit Comput. 2016 Aug;30(4):417-21. doi: 10.1007/s10877-015-9733-4. Epub 2015 Jul 18.
To investigate the role of cerebral oxygen saturation (ScO2) for prediction of hypotension after spinal anesthesia for caesarean section. Forty-five parturients undergoing elective caesarean section under spinal anesthesia were selected. Blood pressure, heart rate and pulse oxygen saturation before and after anesthesia were recorded, and the association between changes in ScO2 before and after anesthesia with hypotension after spinal anesthesia was explored. Hypotension occurred in 32 parturients after spinal anesthesia. The decrease in ScO2 after spinal anesthesia in parturients with hypotension was larger than in parturients without hypotension (P < 0.05). The duration from the intrathecal injection to 5 % decrease in ScO2 was shorter than that from the intrathecal injection to the occurrence of hypotension (P < 0.05). The mean time from 5 % decrease in ScO2 to hypotension was 38 s. The area under the receiver operation characteristic curve was 0.83 for decrease in ScO2 for prediction of hypotension (P < 0.05), and the optimal threshold value was 4.5 %. The sensitivity, specificity, positive predictive value and negative predictive value of 4.5 % decrease in ScO2 for prediction of hypotension were 0.75, 0.78, 0.92 and 0.47, respectively. The decrease in ScO2 after spinal anesthesia is associated with hypotension after spinal anesthesia for cesarean section, and may be a clinically useful predictor.
探讨脑氧饱和度（ScO2）在预测剖宫产脊髓麻醉后低血压中的作用。选取45例行脊髓麻醉下择期剖宫产的产妇。记录麻醉前后的血压、心率和脉搏血氧饱和度，探讨麻醉前后ScO2变化与脊髓麻醉后低血压的相关性。32例产妇脊髓麻醉后发生低血压。低血压产妇脊髓麻醉后ScO2的下降幅度大于未发生低血压的产妇（P<0.05）。从鞘内注射到ScO2下降5%的持续时间短于从鞘内注射到发生低血压的持续时间（P<0.05）。ScO2下降5%至发生低血压的平均时间为38秒。预测低血压时ScO2下降的受试者操作特征曲线下面积为0.83（P<0.05），最佳阈值为4.5%。ScO2下降4.5%预测低血压的灵敏度、特异度、阳性预测值和阴性预测值分别为0.75、0.78、0.92和0.47。脊髓麻醉后ScO2的下降与剖宫产脊髓麻醉后低血压相关，可能是一种临床有用的预测指标。
