[The blood pressure of upper and lower extremities in parturients under spinal anesthesia for cesarean section].
BACKGROUND
In clinical practice, we only measure the blood pressure of the arm during cesarean section. However, it can not accurately reflect the real image of pressure of the lower extremity in labor women. Therefore, we recorded simultaneously the arm and leg blood pressure in the term parturients undergoing cesarean section under spinal anesthesia.


METHODS
After hydration with 1500 ml lactated Ringer's solution, all patients received spinal anesthesia with 2ml (0.5%) spinal heavy bupivacaine. The right hip was elevated 15 degree to insure left uterine displacement. Prior to spinal block blood pressure of the arm and leg was measured and recorded simultaneously using a Criticon Dinamap vital sign monitor 1846sx and was continued in determination every minute thereafter until uterine incision.


RESULTS
We found that monitoring the lower extremity blood pressure might detect the onset of systemic hypotension more earlier and in some instances is disclosed hypotension that was not even detected by the arm cuff monitor. In addition, we found that the blood pressure in the leg was higher than that in the arm, but when hypotension occurred, it might fall even lower than that of the arm.


CONCLUSIONS
We suggest that monitoring blood pressure in cesarean section under spinal anesthesia should be minute to minute for the first ten minutes and one had best monitor the lower extremity blood pressure in order to promptly detect hypotension.
Hui
Y L
YL
Department of Anesthesiology, Chang Gung Memorial Hospital, Keelung, Taiwan, R.O.C.
Wu
Y W
YW
D000328:Adult; D000773:Anesthesia, Obstetrical; D000775:Anesthesia, Spinal; D001132:Arm / Q000098:blood supply; D001794:Blood Pressure; D002585:Cesarean Section; D005260:Female; D006801:Humans; D007866:Leg / Q000098:blood supply; D008875:Middle Aged; D011247:Pregnancy