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脊髓麻醉下剖宫产术中的腹围与低血压发生率

Abdominal Circumference and Hypotension Incidence in Caesarean Section Under Spinal Anaesthesia.

作者信息

Suryawanshi Chhaya, Roshni Yukti

机构信息

Anaesthesiology, Dr. D. Y. Patil Medical College, Hospital and Research Centre, Dr. D. Y. Patil Vidyapeeth, Pune, IND.

出版信息

Cureus. 2024 Sep 7;16(9):e68851. doi: 10.7759/cureus.68851. eCollection 2024 Sep.

Abstract

Hypotension is a common side effect during caesarean deliveries under spinal anaesthesia, influenced by factors like obesity, physiological changes and abdominal circumference (AC). This study delves into the intricate relationship between abdominal circumference and hypotension incidence, spinal anaesthesia levels, hemodynamic shifts, and vasopressor requirements in caesarean sections.  Method: A prospective observational study with 232 term pregnant women undergoing caesarean sections was categorized into two groups based on their abdominal circumference, group A (AC < 95 cm) and group B (AC > 109 cm). The study compared hypotension incidence, achieved spinal anaesthesia levels, hemodynamic changes and ephedrine necessity and dosage between the two groups.  Results: Group B with a larger abdominal circumference, exhibited a significantly higher rate of hypotension, more pronounced hemodynamic changes, higher level of spinal anaesthesia and required more doses of ephedrine to manage hypotension compared to group A with a smaller abdominal circumference.  Conclusion: This study highlights the crucial role of abdominal circumference as a predictive factor for hypotension during caesarean sections under spinal anaesthesia. Recognizing this association enables targeted preventive measures, potentially enhancing maternal and fetal outcomes during such procedures. Awareness of this correlation emphasizes the necessity for tailored interventions to mitigate the risk of hypotension, ensuring safer caesarean deliveries under spinal anaesthesia.

摘要

低血压是腰麻下剖宫产术中常见的副作用,受肥胖、生理变化和腹围(AC)等因素影响。本研究深入探讨腹围与剖宫产术中低血压发生率、腰麻平面、血流动力学变化及血管升压药需求之间的复杂关系。方法:对232例足月行剖宫产术的孕妇进行前瞻性观察研究,根据腹围分为两组,A组(AC<95cm)和B组(AC>109cm)。比较两组的低血压发生率、腰麻平面、血流动力学变化以及麻黄碱的使用必要性和剂量。结果:腹围较大的B组与腹围较小的A组相比,低血压发生率显著更高,血流动力学变化更明显,腰麻平面更高,且需要更多剂量的麻黄碱来处理低血压。结论:本研究强调了腹围作为腰麻下剖宫产术中低血压预测因素的关键作用。认识到这种关联有助于采取针对性的预防措施,可能改善此类手术中母婴结局。意识到这种相关性强调了采取针对性干预措施以降低低血压风险的必要性,确保腰麻下剖宫产更安全。

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