การศึกษาอุบัติการณ์และปัจจัยที่สัมพันธ์กับภาวะความดันโลหิตต่ำจากการฉีดยาชาเข้าช่องน้ำไขสันหลังในผู้ป่วยที่เข้ารับการผ่าตัดในโรงพยาบาลโพธาราม

Napaporn  Sookseenlumlert

Authors

Napaporn Sookseenlumlert Photharam Hospital

Keywords:

hypotension, spinal anesthesia, factors, incidence

Abstract

ABSTRACT

Objective : This study aimed to investigate the incidence and identify the associated factors of hypotension after spinal anesthesia at Photharam hospital.
Methods : A prospective cohort study was conducted on 234 surgical patients with spinal anesthesia at Photharam hospital from September 2020 to December 2021. Patient data, anesthetic data, and surgical data were collected. Hypotension was defined as a decrease of systolic blood pressure by more than 20% of baseline or lesser than 90 mmHg. Results : The incidence of hypotension after spinal anesthesia was 61.1%. The univariate analysis showed the associated factors of hypotension after spinal anesthesia were sex, body weight, height, body mass index, baseline systolic blood pressure, baricity of bupivacaine, and anesthetic level. The multivariate analysis of significant factors on univariate analysis identified those associated with hypotension as baseline systolic blood pressure and anesthetic level. Every one mmHg baseline systolic blood pressure increment increased the risk of hypotension by 3.2% (95% Confidence interval: 1.01 - 1.05, p-value<0.01). Compared to the thoracic (T) 11 level or below, the anesthetic level at T5 or above and T6-T10 level increased the risk of hypotension 12.21 times (95% Confidence interval: 3.35 - 44.51, p-value<0.05) and 3.34 times (95% Confidence interval: 1.37 - 8.13, p-value<0.05), respectively.
Conclusion : Increased baseline systolic blood pressure and anesthetic level associated with hypotension after spinal anesthesia.
Keywords : hypotension, spinal anesthesia, factors, incidence

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