Anesth Pain Med.  2012 Oct;7(4):355-358.

The impact of anthrometric measurements on hypotension during spinal anesthesia for cesarean delivery: comparison of body weight, body height, body mass index, and abdominal circumference

• Song IA
• Shin WK
• Hyun SJ
• Park SJ
• Ryu J
• Jeon YT
• Hwang JW
• Do SH

Abstract

BACKGROUND
Hypotension is a common complication of spinal anesthesia for cesarean delivery. The incidence and severity of hypotension is reported higher compared with other surgeries due to aortocaval compression. We evaluated whether body weight, body height, body mass index (BMI) and abdominal circumference effected on the incidence of hypotension and ephedrine requirement.
METHODS
A total of 55 parturients undergoing elective cesarean delivery were enrolled in this prospective observational study. Preeclampsia or eclampsia was excluded. Abdominal circumference, body weight, body height were assessed before anesthesia. Spinal anesthesia was conducted in the right lateral position using 8 mg of 0.5% hyperbaric bupivacaine and 15 microg of fentanyl. Blood pressure was measured before anesthesia and at 1 min interval after intrathecal injection. Nausea was assessed during spinal anesthesia. Hypotension was defined that blood pressure decreased below 80% of baseline value and ephedrine was given if blood pressure dropped below 70% (severe hypotension).
RESULTS
The total incidence of hypotension was 65% (36/55) and ephedrine was administered in 38% (21/55) of parturients. Except height, abdominal circumference, body weight and body mass index were associated with the incidence of hypotension (P < 0.05). However, severe hypotension requiring ephedrine (P = 0.001, OR = 1.16, [95% CI 1.04-1.30]), ephedrine requirement (P = 0.001, R = 0.43) and nausea (P = 0.026, R = 0.31) were significantly related only with abdominal circumference.
CONCLUSIONS
Abdominal circumference of parturients may be a good parameter to predict both of the incidence and the severity of hypotension during spinal anesthesia for cesarean delivery.

Keyword

Abdominal circumference; Body mass index; Body weight; Cesarean section; Hypotension; Spinal anesthesia

MeSH Terms

Anesthesia
Anesthesia, Spinal
Blood Pressure
Body Height
Body Mass Index
Body Weight
Bupivacaine
Cesarean Section
Eclampsia
Ephedrine
Female
Fentanyl
Hypotension
Incidence
Injections, Spinal
Nausea
Pre-Eclampsia
Pregnancy
Prospective Studies
Bupivacaine
Ephedrine
Fentanyl