Abstract
Introduction: The involvement of the endothelial dysfunction (ED) in arterial hypotension (AHPT) post of spinal anesthesia (SA) has not been established. Objective: To determine if there is a relationship between ED and AHPT observed during the 1st 15 minutes after SA. Population and Methods: The study concerned 40 people who were to benefit from a programmed herniorrhaphy under SA and 40 controls (SA-). The correlations between mean plasma concentrations of endothelin-1 (CmET-1, pg/ml) and Vascular Cell Adhesion Molecule-1 (CmVCAM-1, pg/ml) taken from SA+ one hour before (H0), then 15 minutes after the SA (H15) and the mean arterial pression (AMP, mmHg) with heart rate (bpm) were analyzed (p - were 1.07 and 3.34, respectively, compared to 1.12 (p = 0.735) and 3.57 (p = 0.862) in SA+ at H0 and H15. In SA+, at H15, CmET-1 was 1.13 (p = 0.823) and CmVCAM-1 was 3.57 (p = 0.257). In SA-, a negative correlation existed between CmET-1 and CmVCAM-1 (r = -0.438; p = 0.005). Conversely, in SA+, whether at H0 (r = -0.31; p = 0.051) or at H15 (r = 0.024; p = 0.883), no correlation existed between CmET-1 and CmVCAM-1, nor between MAP and ED markers (r = 0.111; p = 0.325). Conclusion: These results show that there is no relationship between the AHPT which occurs during the first fifteen minutes post SA, CmVCAM-1 and CmET-1. Moreover, these data suggest that ED is not involved in AHPT post SA.
Highlights
The involvement of the endothelial dysfunction (ED) in arterial hypotension (AHPT) post of spinal anesthesia (SA) has not been established
Open Access tween Comparison of the Mean Plasma ET-1 (CmET-1) and CmVCAM-1, nor between MAP and ED markers (r = 0.111; p = 0.325). These results show that there is no relationship between the AHPT which occurs during the first fifteen minutes post SA, CmVCAM-1 and CmET-1
These data suggest that ED is not involved in AHPT post SA
Summary
The involvement of the endothelial dysfunction (ED) in arterial hypotension (AHPT) post of spinal anesthesia (SA) has not been established. When performed as part of sub umbilical surgery, it causes blockage of the vegetative system in favor of the para sympathetic system [14] [15] [16] This blockage would result in the installation of arterial hypotension, whose link with ED has not yet been clearly established [10]-[16]. Our hypothesis is that endothelial ED, like sympathetic paralysis, would be involved in the onset of low blood pressure observed during the first fifteen minutes after SA. To confirm this hypothesis, we monitored mean arterial pressure, as well as heart rate, assayed plasma markers of ED, and analyzed their correlations in patients before and 15 minutes after intra spinal administration of a loco regional anesthetic
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