Gebrargs Leake, Gebremeskel Bereket, Aberra Bacha, Hika Assefa, Yimer Yusuf, Weldeyohannes Misrak, Jemal Suleiman, Behrey Degena, Tilahun Abere
Department of Anesthesiology, College of Health Sciences, Aksum University, Axum, Ethiopia.
Department of Anesthesiology, College of Health Sciences, Addis Ababa University, Addis Ababa, Ethiopia.
Anesthesiol Res Pract. 2021 Jul 13;2021:8891252. doi: 10.1155/2021/8891252. eCollection 2021.
Hypotension and bradycardia are the most common complications associated with spinal anesthesia and more common in patients with a history of hypertension. Regular use of antihypertensive medications can prevent these complications. The occurrence of hypotension under spinal anesthesia among controlled hypertensive and normotensive patients with age 40 years and above is still debated. The objective of the study was to compare blood pressure and heart rate changes following spinal anesthesia between controlled hypertensive and normotensive patients undergoing surgery below the umbilicus at Black lion hospital, Addis Ababa, Ethiopia, 2020.
A hospital-based prospective cohort study was conducted. A total of 110 elective patients with controlled hypertension (55) and normotensive (55) patients who underwent surgery with spinal anesthesia at black lion hospital during the study period were included. The sample was selected using a systematic random sampling technique. Continuous data of independent and dependent variables were analyzed using an independent sample -test for normally distributed and Mann-Whitney -test for nonnormally 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 value <0.05 was considered statistically significant.
The incidence of hypotension in the controlled hypertension group (23.6%) was higher than the normotensive group (7.3%) with value of 0.018. The occurrence of bradycardia was seen to be 12.7% in each group with a value >0.05. There was a statistically 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.
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 statistically significant difference between the two groups.
低血压和心动过缓是与脊髓麻醉相关的最常见并发症，在有高血压病史的患者中更为常见。定期使用抗高血压药物可预防这些并发症。40岁及以上的控制高血压患者和血压正常患者在脊髓麻醉下发生低血压的情况仍存在争议。本研究的目的是比较2020年在埃塞俄比亚亚的斯亚贝巴黑狮医院接受脐以下手术的控制高血压患者和血压正常患者在脊髓麻醉后的血压和心率变化。
进行了一项基于医院的前瞻性队列研究。纳入了研究期间在黑狮医院接受脊髓麻醉手术的总共110例择期控制高血压患者（55例）和血压正常患者（55例）。样本采用系统随机抽样技术选取。研究组之间独立变量和因变量的连续数据，对于正态分布的使用独立样本t检验，对于非正态分布的使用曼-惠特尼检验进行分析。研究组之间的分类变量使用卡方检验进行分析。描述性数据使用表格和图表展示。对于连续和分类变量，p值<0.05被认为具有统计学意义。
控制高血压组低血压发生率（23.6%）高于血压正常组（7.3%），p值为0.018。每组心动过缓发生率均为12.7%，p值>0.05。在测量时间间隔内，控制高血压组和血压正常组之间的平均收缩压、平均动脉压、平均心率和血管加压药消耗量存在统计学显著差异。
在脊髓麻醉下，控制高血压患者比血压正常患者更易发生低血压，但在心动过缓的发生方面，两组之间无统计学显著差异。
