A PROSPECTIVE STUDY IN PREDICTING POST–SPINAL HYPOTENSION IN PATIENTS UNDERGOING A CAESAREAN SECTION THROUGH PREOPERATIVE BASELINE HEART RATE

Dr. Aparna Bagle; Dr. Shreyank Premchand Solanki; Dr. Tanya Gulia; Dr. Shivangi Singh; Dr. Spoorti Pujari

Volume : IX, Issue : IX, September - 2019

A PROSPECTIVE STUDY IN PREDICTING POST–SPINAL HYPOTENSION IN PATIENTS UNDERGOING A CAESAREAN SECTION THROUGH PREOPERATIVE BASELINE HEART RATE

Dr. Aparna Bagle, Dr. Shreyank Premchand Solanki, Dr. Tanya Gulia, Dr. Shivangi Singh, Dr. Spoorti Pujari

Abstract :

Introduction: Spinal anesthesia for caesarean section has several advantages over general anaesthesia , the most common complication of spinal anesthesia in pregnant patient is hypotension. Preoperative determination of the autonomic tone might provide an opportunity to detect patients at risk of developing severe hemodynamic impairment following spinal anaesthesia. There are several methods to determine autonomic tone. Of these, a convenient, handy and non–invasive method of measuring activity of ANS is analysis of heart rate. Method: This is a Prospective, randomized, double blinded study done over a period of 5 months, data will be collected from 100 ASA–I and ASA–II fit patients scheduled for elective caesarean delivery under subarachnoid block. The patients will be divided into two groups of 50 each, first group will be the patients with preoperative HR below 90bpm and the second group will be patients with HR above 90bpm. Written informed consent was taken from all the patients. Blood pressure measurement will be recorded immediately after spinal at regular intervals till end of surgery. Results: There was no statistical difference between the two groups in terms of age, weight, height and duration of surgery. In the group with HR greater then 90bpm, 27 patients developed hypotension where as in the group with HR lower than 90bpm 11 patients developed hypotension. This difference is statistically significant (p<0.05). Conclusion: Patients with a higher preoperative HR are more likely to develop post–spinal hypotension than patients with lower HR, thus pre–operative Heart rate can predict post–spinal hypotension in patients of caesarean section who have been given spinal anesthesia.