Sari M, Sargin M, Okucu F
Department of Anaesthesiology and Reanimation, Bezmialem Vakif University, Istanbul, Turkiye.
Department of Anesthesiology and Reanimation, Selcuk University, Konya, Turkiye.
Niger J Clin Pract. 2025 Jul 1;28(7):790-796. doi: 10.4103/njcp.njcp_195_25. Epub 2025 Jul 28.
Spinal anesthesia (SA) is the preferred method for cesarean delivery, though it is often associated with maternal hypotension. Predicting hypotension can enhance clinical decision-making, optimize management strategies, and improve patient outcomes.
We aimed to test the association between circadian rhythm and the incidence of hypotension during spinal anesthesia for cesarean delivery.
This prospective observational study included women undergoing cesarean delivery with spinal anesthesia, excluding those with inadequate anesthesia or major comorbidities. Patients were divided into morning (6:00-12:00) and afternoon (12:00-18:00) groups based on C-section time. Hemodynamic variables, total ephedrine dosage, and incidence of nausea, vomiting, and hypotension were assessed, with hypotension as the primary outcome.
Out of 231 screened patients, 203 were enrolled, and 200 patients were analyzed. 114 were allocated to Group morning and 86 to Group afternoon. The overall incidence of hypotension was 66%, with severe hypotension occurring at a significantly higher rate in the morning group compared to the afternoon group (43% vs. 30.2%, P = 0.028).
Our findings suggest that the timing of cesarean delivery may influence the incidence of spinal anesthesia-induced hypotension, underscoring the potential clinical value of considering circadian factors when scheduling procedures to optimize maternal hemodynamic stability.
脊髓麻醉（SA）是剖宫产的首选方法，尽管它常与产妇低血压相关。预测低血压可增强临床决策、优化管理策略并改善患者预后。
我们旨在测试昼夜节律与剖宫产脊髓麻醉期间低血压发生率之间的关联。
这项前瞻性观察性研究纳入了接受脊髓麻醉剖宫产的女性，排除麻醉不足或有重大合并症的患者。根据剖宫产时间将患者分为上午组（6:00 - 12:00）和下午组（12:00 - 18:00）。评估血流动力学变量、麻黄碱总用量以及恶心、呕吐和低血压的发生率，以低血压作为主要结局。
在231名筛查患者中，203名被纳入研究，200名患者进行了分析。114名被分配到上午组，86名被分配到下午组。低血压的总体发生率为66%，上午组严重低血压的发生率显著高于下午组（43%对30.2%，P = 0.028）。
我们的研究结果表明，剖宫产的时间可能会影响脊髓麻醉引起的低血压发生率，强调了在安排手术时考虑昼夜因素以优化产妇血流动力学稳定性的潜在临床价值。
