The Prediction And Prevention Of Spınal Anaesthesıa-Induced Hypotensıon With Perfusion İndex And The Effect Of Crystalloid

Abstract

Hypotension is a dangerous and common problem for patients under spinal anesthesia. Spinal anesthesia-induced hypotension(SIH) is often arisen from heart rate decrease and venous blood pooling under the spinal block level because of sympathetic blockage. Prediction and prevention of hypotension will be beneficial for the patients' health under spinal blockage. For prediction, many parameters like perfusion index(PI) have been using. This study aims to research the correlation between the patients' hemodynamic parameters, perfusion indices before spinal block and SIH, and the effectiveness of crystalloid preload before spinal block to the usage of ephedrine. Records from 101 patients between 18-100 years age, who underwent surgery with spinal anesthesia were studied. We enroll patients demografical characteristics, ASA-score, sensory-blockage level, opereation period, the patients' position for spinal block, local anethesic form-dosage, blockage level, patients' hemodynamic and PI parameters in the surgery, hypotension time, efedrin first usage time and dosage from records. These results analyzed with t-test, Pearson-Chi-Square, Wilcoxon-signed-rank and Mann-Whitney-U test. SIH were seen in 25,7% of patients. The incidence of hypotension increases with age and block level. Any corelation between SIH and PI degrees before spinal block was not found, but MAP degrees before spinal block were significantly different in hypotension group. 10ml/kg cristaloid-preload was used 37,6% of patients. SIH was not prevented by cristaloid-preload and cristaloid-preload didn’t affect efedrine dosage-timing. Cristaloid-preload changed significantly patients heart rate and PI. In this study, we found that PI was not predictive factor for the development of SIH. Besides cristaloid-preload don’t avoid development of SIH.