Is it possible to predict hypotension during onset of spinal anesthesia in elderly patients?

Research output: Contribution to journalJournal articleResearchpeer-review

Christian S Meyhoff, Christian Haarmark, Jørgen K Kanters, Lars S Rasmussen

STUDY OBJECTIVE: To evaluate the sensitivity and specificity of various predictors of hypotension during onset of spinal anesthesia in elderly patients. DESIGN: Prospective study. SETTING: 32 ASA physical status I, II, and III patients, aged >or=60 years, scheduled for elective lower limb surgery with spinal anesthesia. INTERVENTIONS: Patients received spinal anesthesia with 10-17.5 mg of bupivacaine. No prophylactic ephedrine or fluid preloading was used. MEASUREMENTS: A 5-minute baseline was recorded and during onset of spinal anesthesia, hemodynamic changes were measured every 10 seconds from the radial artery pressure curve. Data collection ended when patients were ready for surgery, or if ephedrine was given to increase mean arterial pressure. MAIN RESULTS: 21 patients had hypotension. Baseline blood pressure variability low-frequency band power (BPV LF) >8 mmHg(2) and near-infrared spectroscopy (NIRS) reduction >or=5% had high sensitivity (0.73 and 0.90, respectively) and specificity (0.78 and 0.64, respectively), and were significantly associated with the development of hypotension. CONCLUSIONS: Only NIRS and BPV LF could significantly predict hypotension among the elderly.
Original languageEnglish
JournalJournal of Clinical Anesthesia
Volume21
Issue number1
Pages (from-to)23-9
Number of pages6
ISSN0952-8180
DOIs
Publication statusPublished - 2009

Bibliographical note

Keywords: Adrenergic Agents; Aged; Aged, 80 and over; Anesthesia, Spinal; Anesthetics, Local; Blood Pressure Determination; Bupivacaine; Ephedrine; Female; Heart Rate; Hemodynamics; Humans; Hypotension; Lower Extremity; Male; Middle Aged; Predictive Value of Tests; Prospective Studies; Radial Artery

ID: 18763937