Document Detail


Definitions of hypotension after spinal anaesthesia for caesarean section: literature search and application to parturients.
MedLine Citation:
PMID:  20455872     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
BACKGROUND: Spinal anaesthesia for caesarean section may cause hypotension, jeopardizing the foetus and its mother. We aimed to identify the spectrum of definitions of hypotension used in the scientific literature. In a second part, we applied these definitions to a prospective cohort in order to evaluate the effect of different definitions on the incidence of hypotension.
METHODS: A systematic literature search in PubMed was performed from 1999 to 2009 with the search terms 'hypotension' and 'caesarean section'. Consecutive parturients undergoing caesarean section under spinal anaesthesia were included in a prospective study.
RESULTS: Sixty-three eligible publications (7120 patients) were retrieved, revealing 15 different definitions of hypotension. A decrease below 80% baseline and the combined definition of a blood pressure below 100 mmHg or a decrease below 80% baseline were the two most frequent definitions, found in 25.4% and 20.6% of the papers, respectively. When applying the spectrum of definitions to a prospective cohort, the incidences of hypotension varied between 7.4% and 74.1%. The incidence increased from 26.7% to 38.5% when using a value below 75% of baseline instead of below 70% of baseline.
CONCLUSION: There is not one accepted definition of hypotension in the scientific literature. The incidence of hypotension varies depending on the chosen definition. Even minor changes of the definition cause major differences in the frequency of hypotension. This makes it difficult to compare studies on interventions to treat/prevent hypotension and probably hampers progress in this area of research.
Authors:
S Klöhr; R Roth; T Hofmann; R Rossaint; M Heesen
Publication Detail:
Type:  Journal Article; Meta-Analysis; Review     Date:  2010-04-23
Journal Detail:
Title:  Acta anaesthesiologica Scandinavica     Volume:  54     ISSN:  1399-6576     ISO Abbreviation:  Acta Anaesthesiol Scand     Publication Date:  2010 Sep 
Date Detail:
Created Date:  2010-08-12     Completed Date:  2010-12-02     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  0370270     Medline TA:  Acta Anaesthesiol Scand     Country:  England    
Other Details:
Languages:  eng     Pagination:  909-21     Citation Subset:  IM    
Affiliation:
Klinik für Anästhesie, Operative Intensivmedizin und Schmerztherapie, Klinikum Bamberg, Bamberg, Germany.
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MeSH Terms
Descriptor/Qualifier:
Adult
Anesthesia, Spinal / adverse effects*
Blood Pressure / physiology
Cesarean Section / adverse effects*,  statistics & numerical data
Female
Humans
Hypotension / diagnosis,  epidemiology,  physiopathology*
Postoperative Complications / epidemiology,  physiopathology*
Pregnancy
Terminology as Topic*
Comments/Corrections
Comment In:
Acta Anaesthesiol Scand. 2010 Sep;54(8):907-8   [PMID:  20701595 ]

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine


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