Incidence and predictors of hypotension following spinal anaesthesia in adult surgical patients: A hospital-based prospective cohort study.
DOI:
https://doi.org/10.51168/61963991Cuvinte cheie:
adult surgical patients, haemodynamic instability, hypotension, predictors, spinal anaesthesia, vasopressorsRezumat
Background:
Hypotension is a frequent haemodynamic complication of spinal anaesthesia and can compromise organ perfusion, particularly in older adults and patients with limited cardiovascular reserve.
Objectives:
To determine the incidence, clinical pattern, and independent predictors of hypotension following spinal anaesthesia in adult surgical patients.
Methods:
This hospital-based prospective cohort study included 100 adults undergoing spinal anaesthesia for surgery at the Government Medical College/Government General Hospital, Nizamabad, Telangana, India, from July 2025 to February 2026. Hypotension was defined as systolic blood pressure below 90 mmHg or a reduction of at least 30% from baseline. Demographic, clinical, anaesthetic, block-related, and haemodynamic variables were recorded. Independent predictors were identified using multivariable logistic regression.
Results:
Hypotension occurred in 38 patients, giving an incidence of 38.0% (95% confidence interval: 29.1–47.8%). The median time to the first episode was 9 minutes, and 76.3% of episodes occurred within 15 minutes of intrathecal injection. Vasopressors were required in 30 affected patients. Bradycardia was more frequent in the hypotension group than in the stable group (26.3% versus 6.5%). Age of at least 60 years, baseline mean arterial pressure below 90 mmHg, intravenous preload below 500 mL, and a sensory block at or above T6 independently predicted hypotension.
Conclusion:
Hypotension affected more than one-third of adults receiving spinal anaesthesia and developed predominantly during the early post-block period. Advanced age, low baseline arterial pressure, inadequate fluid preload, and higher sensory blockade identified patients at increased risk.
Recommendations:
Pre-block risk assessment, adequate volume optimisation, close monitoring during the first 15 minutes, and prompt vasopressor availability should form part of routine spinal-anaesthesia practice.
Referințe
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Copyright (c) 2026 Dr. Chintala Kishan, Dr. CH. Nagaraju, Dr. K. Prathyusha
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