Effect of spinal anesthesia on the ratio of agreement between the lower and upper extremity pressures in lower abdominal surgeries

Abstract

Background: During spinal anesthesia, blood pressure is often measured indirectly through inflating a cuff at the arm. However, the measurement of blood pressure at the arm is sometimes not possible due to the presence of burns and implementation of orthopedic or plastic surgery on the upper limb. In these cases, lower extremity blood pressure should be measured. Materials and Methods: This descriptive analytical study was conducted on 34 candidates for lower abdominal surgery. The blood pressure cuff was first placed on the right arm and leg, and then on the left arm and leg. The recorded variables included the region of measuring blood pressure, blood pressure, duration of surgery, and type of surgery. The agreement between the lower and upper extremity pressures at any time was determined using the Bland-Altman graphical method. Results: According to the results, 32 patients were male. The graphical analysis revealed 5 min after spinal anesthesia, systolic, diastolic, and mean blood pressures of the right hand and leg were approximately equal. Conclusion: The results indicated an agreement among the systolic, diastolic, and mean blood pressures of the right hand and leg 5 min after spinal anesthesia. The agreement between arterial systolic blood pressure was greater than those of the diastolic blood pressure and mean arterial pressure. Regarding this, we can recommend that when the arm is unreachable to measure arterial blood pressure or the accuracy of measured pressure is not guaranteed, ankle can be used as an alternative.