Vahabi Sepideh, Karimi Arash, Beiranvand Siavash, Ghafarzadeh Masoumeh, Mousavi Roghaye
Department of Anesthesiology, Faculty of Medicine, Lorestan University of Medical Sciences, Khorramabad, Iran.
Department of Obstetrics and Gynecology, School of Medicine, Lorestan University of Medical Sciences, Khorramabad, Iran.
Ann Med Surg (Lond). 2022 Sep 16;82:104649. doi: 10.1016/j.amsu.2022.104649. eCollection 2022 Oct.
Hemodynamic changes occur in almost one-third of patients undergoing spinal anesthesia, which are likely to effect vital organ. The aim of this study is to determine the hemodynamic effect of spinal anesthesia during different phases of menstrual cycle.
This is a descriptive cross-sectional study, two hundred and seventy-three patients who underwent spinal anesthesia for elective surgery were enrolled in this study. Of all the patients, 141 patients were in the luteal phase and 132 patients were in the follicular phase of their menstrual cycle. Analytical epidemiological study was conducted using questionnaires. Blood pressure and heart rate of patients before, immediately after, and 1 h after spinal anesthesia were recorded, and the data were analyzed using SPSS software.
In the follicular phase before anesthesia, systolic blood pressure (SBP) was 127.5 ± 3.9, diastolic blood pressure (DBP) was 80.3 ± 6.2 mmHg and heart rate (HR) was 82.0 ± 8.5bpm, while, immediately after the induction of anesthesia following recordings were measured; 109.7 ± 9.13, 71.8 ± 2.8 mmHg and 70.0 ± 8.10bpm, respectively. In the luteal phase, it was 126.9 ± 3.12, 81.6 ± 9.3 mmHg and 80.2 ± 4.4bpm, and 122.0 ± 9.12, 78.6 ± 8.5 mmHg and 75.9 ± 6.5bpm respectively before and immediately after anesthesia, these changes in the menstrual phase was significant (P < 0.001). In the follicular phase an hour after spinal anesthesia, the mean SBP was 100.3 ± 3.9, DBP was 71.2 ± 7.5, MAP was 87.0 ± 4.7 mmHg and HR 67.5 ± 5.7bpm and following was seen in luteal phase; 115.4 ± 1.8, 75.9 ± 2.3, 97.3 ± 3.5 mm Hg and 74.0 ± 7.4bpm, respectively. These values were significantly lower in the follicular phase (P < 0.001).
Spinal anesthesia in the luteal phase as compared to the follicular phase of the menstrual cycle shows less variation in hemodynamic parameters.
近三分之一接受脊髓麻醉的患者会出现血流动力学变化，这可能会影响重要器官。本研究的目的是确定月经周期不同阶段脊髓麻醉对血流动力学的影响。
这是一项描述性横断面研究，纳入了273例接受择期手术脊髓麻醉的患者。所有患者中，141例处于月经周期的黄体期，132例处于卵泡期。使用问卷进行分析性流行病学研究。记录患者在脊髓麻醉前、麻醉后即刻和麻醉后1小时的血压和心率，并使用SPSS软件对数据进行分析。
在卵泡期麻醉前，收缩压（SBP）为127.5±3.9，舒张压（DBP）为80.3±6.2mmHg，心率（HR）为82.0±8.5次/分钟，而在麻醉诱导后即刻测量的记录分别为109.7±9.13、71.8±2.8mmHg和70.0±8.10次/分钟。在黄体期，麻醉前分别为126.9±3.12、81.6±9.3mmHg和80.2±4.4次/分钟，麻醉后即刻分别为122.0±9.12、78.6±8.5mmHg和75.9±6.5次/分钟，月经周期中的这些变化具有显著性（P<0.001）。在卵泡期脊髓麻醉后1小时，平均SBP为100.3±3.9，DBP为71.2±7.5，平均动脉压（MAP）为87.0±4.7mmHg，HR为67.5±5.7次/分钟，黄体期的情况如下：分别为115.4±1.8、75.9±2.3、97.3±3.5mmHg和74.0±7.4次/分钟。这些值在卵泡期显著较低（P<0.001）。
与月经周期的卵泡期相比，黄体期进行脊髓麻醉时血流动力学参数的变化较小。
