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, In Ae; Shin, Woo kyung; Hyun, Sun ji; Park, Seong Joo; Ryu, Junghee; Jeon, Young Tae; Hwang, Jung Won; Do, Sang Hwan

Clinical Research

Obstetric Anesthesia

Anesthesia and Pain Medicine 2012;7(4):355-358.
Published online October 31, 2012.

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

In Ae Song, Woo kyung Shin, Sun ji Hyun, Seong Joo Park, Junghee Ryu, Young Tae Jeon, Jung Won Hwang, Sang Hwan Do

Department of Anesthesiology and Pain Medicine, Seoul National University Bundang Hospital, Seongnam, Korea. jungwon@snubh.org

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.

Key Words: Abdominal circumference, Body mass index, Body weight, Cesarean section, Hypotension, Spinal anesthesia