Comparison of non-invasive blood pressure measurements on the arm and calf during cesarean delivery.
OBJECTIVE
Shivering may occur in 75% of women undergoing spinal anesthesia for cesarean delivery and may render an automated noninvasive blood pressure (ANIBP) device incapable of determining blood pressurc (BP). When patients shiver under spinal anesthesia, the lower extremities do not exhibit the same involuntary muscle movements as do the upper extremities. This study was undertaken to determine if a correlation exists between ANIBP measurements in the arm and calf of women undergoing cesarean delivery under spinal anesthesia.


METHODS
We enrolled 73 women in this blinded, prospective study. Simultaneous arm and calf BP were measured with an ANIBP and differences between the two were determined.


RESULTS
We found significant differences between the average difference in systolic and in diastolic BP, no significant difference between the average mean BP, and a tendency for the systolic BP to be higher and the diastolic BP to be lower in the calf than in the arm; however, there was a large degree of variability among patients.


CONCLUSIONS
We conclude that there is a poor correlation between the BP measured by an ANIBP on the calf and one on the arm. In the parturient undergoing cesarean section, lower extremity BP as measured by an ANIBP does not correlate with the arm ANIBP and should not be used to assure fetal well being.
Zahn
J
J
Department of Anesthesiology, Mount Sinai School of Medicine, One Gustave L. Levy Place, Box 1010, New York, NY 10029-6574, USA. Rakinroll@aol.com
Bernstein
H
H
Hossain
S
S
Bodian
C
C
Beilin
Y
Y
D000773:Anesthesia, Obstetrical; D000775:Anesthesia, Spinal; D001132:Arm; D001794:Blood Pressure; D001795:Blood Pressure Determination; D002585:Cesarean Section; D004311:Double-Blind Method; D005260:Female; D006801:Humans; D007866:Leg; D011247:Pregnancy; D011446:Prospective Studies; D012768:Shivering / Q000502:physiology