Bimbo-Szuhai Erika, Botea Mihai Octavian, John Harrie Toms, Danciu Adela Bostan, Razvan Pirvan Titus, Bontea Mihaela Gabriela, Pavel Mihai, Salajan Caius, Rusu Maria Viviana, Osiceanu Adrian Gheorghe, Macovei Iulia Codruta
Department of Morphological Disciplines, Faculty of Medicine and Pharmacy, University of Oradea, 1st December Square 10, 410073 Oradea, Romania.
Pelican Hospital, Corneliu Coposu Street 2, 410450 Oradea, Romania.
Clin Pract. 2025 Sep 15;15(9):166. doi: 10.3390/clinpract15090166.
The primary goal of the study is to analyze factors associated with spinal anesthesia-induced hypotension (SAIH), with a focus on ephedrine requirements in relation to patient characteristics and the type of intrathecal opioid used, reflecting real-world clinical practice in a Romanian secondary care hospital. Bolus ephedrine is often required during spinal anesthesia to maintain hemodynamic stability. We conducted a retrospective observational study of patients undergoing total hip arthroplasty. We analyzed the hemodynamic effects of spinal anesthesia to optimize management of spinal anesthesia-induced hypotension (SAIH). A total of 329 patients were included in the study, out of which 113 patients were without high blood pressure (60 cases needed Ephedrine) and 216 patients with high blood pressure were drug controlled (106 cases needed Ephedrine). Each group of patients was divided into two groups based on the type of spinal anesthesia: bupivacaine with morphine (Group M) and bupivacaine with fentanyl (Group F). The study explored perioperative factors associated with spinal anesthesia-induced hypotension and the ephedrine dose required to maintain hemodynamic stability. We found that ephedrine dosage correlated with hypertension in 19% of cases and with patient age in 44.1% of cases. The type of anesthetic mixture did not significantly affect the need for intraoperative ephedrine administration. Ephedrine remains essential for ensuring hemodynamic stability and optimizing perioperative outcomes.
该研究的主要目标是分析与脊髓麻醉诱导的低血压（SAIH）相关的因素，重点关注与患者特征以及所用鞘内阿片类药物类型相关的麻黄碱需求量，以反映罗马尼亚二级护理医院的实际临床实践。在脊髓麻醉期间通常需要静脉推注麻黄碱以维持血流动力学稳定。我们对接受全髋关节置换术的患者进行了一项回顾性观察研究。我们分析了脊髓麻醉的血流动力学效应，以优化对脊髓麻醉诱导的低血压（SAIH）的管理。该研究共纳入329例患者，其中113例无高血压（60例需要麻黄碱），216例高血压患者药物控制良好（106例需要麻黄碱）。每组患者根据脊髓麻醉类型分为两组：布比卡因加吗啡组（M组）和布比卡因加芬太尼组（F组）。该研究探讨了与脊髓麻醉诱导的低血压相关的围手术期因素以及维持血流动力学稳定所需的麻黄碱剂量。我们发现，19%的病例中麻黄碱剂量与高血压相关，44.1%的病例中与患者年龄相关。麻醉合剂类型对术中麻黄碱给药的需求没有显著影响。麻黄碱对于确保血流动力学稳定和优化围手术期结局仍然至关重要。
