title: The effect of head-down tilt on arterial blood pressure after spinal anesthesia.
abstract: We examined the usefulness of 10 degrees head-down tilt for hypotension after spinal block. Two different investigations were performed, one employing head-down tilt after arterial blood pressure had decreased (n = 40), and the other using a prophylactic tilt (n = 50). When the head-down tilt was applied to treat hypotension after spinal block (n = 40), arterial blood pressure increased only in patients whose systemic blood pressure decreased more than 30% from the control (severe hypotension group, n = 11). However, even in the severe hypotension group, systolic blood pressure did not increase in two patients after 10 degrees head-down tilt. When the head-down tilt was performed immediately after spinal block (n = 24), the changes in systolic blood pressure were the same as in the horizontal group (n = 26). The cephalad spread of analgesia at 20 min after spinal block was higher, however, in the head-down tilt group (T3.8 +/- 1.6) than the horizontal group (T5.2 +/- 1.9). From these results we conclude that head-down tilt for hypotension after spinal block increases arterial blood pressure only for severe hypotension, and that prophylactic head-down tilt has no effect in maintaining blood pressure.
authors.affiliation: Department of Anesthesia, Kushiro City General Hospital, Japan.
authors.forename: M
authors.initials: M
authors.lastname: Miyabe
authors.forename: A
authors.initials: A
authors.lastname: Namiki
mesh_terms: D000328:Adult; D000775:Anesthesia, Spinal / Q000009:adverse effects*; D001794:Blood Pressure / Q000502:physiology*; D005260:Female; D005831:Genital Diseases, Female / Q000503:physiopathology / Q000601:surgery*; D006801:Humans; D007022:Hypotension / Q000209:etiology* / Q000503:physiopathology / Q000517:prevention & control; D008875:Middle Aged; D011187:Posture