title: Positional blood pressure change and the risk of hypotension during spinal anesthesia for cesarean delivery: an observational study.
abstract: BACKGROUND
  We investigated whether preoperative positional arterial blood pressure change predicted hypotension and ephedrine requirement during spinal anesthesia for cesarean delivery.
  
  
  METHODS
  Arterial blood pressure was measured in 66 women undergoing cesarean delivery in the supine and the right lateral positions. Positional blood pressure change was defined as the difference between mean blood pressure in the right lateral and supine positions. Hypotension (<80% baseline) was recorded, and severe hypotension (<70% baseline) was treated with ephedrine.
  
  
  RESULTS
  The mean (range) positional blood pressure change was 11 (3-29) mm Hg, and the incidence of hypotension was 41%. Positional blood pressure change and heart rate correlated with hypotension (P < 0.001 for both) and ephedrine requirement (P = 0.004). Positional blood pressure change in those who developed hypotension was higher than for those without hypotension (mean (SD), 17 (6) vs. 7 (2) mm Hg, P < 0.001).
  
  
  CONCLUSIONS
  A preoperative increase in blood pressure after position change may be a good variable to predict hypotension during spinal anesthesia for cesarean delivery.
authors.affiliation: Department of Anesthesia and Pain Medicine, Seoul National University Bundang Hospital, 300 Gumidong, Bundang, Seongnam, Kyonggi 463-707 South Korea.
authors.forename: Young-Tae
authors.initials: YT
authors.lastname: Jeon
authors.forename: Jung-Won
authors.initials: JW
authors.lastname: Hwang
authors.forename: Mi-Hyun
authors.initials: MH
authors.lastname: Kim
authors.forename: Ah-Young
authors.initials: AY
authors.lastname: Oh
authors.forename: Kyo Hoon
authors.initials: KH
authors.lastname: Park
authors.forename: Hee-Pyoung
authors.initials: HP
authors.lastname: Park
authors.forename: Younsuk
authors.initials: Y
authors.lastname: Lee
authors.forename: Sang-Hwan
authors.initials: SH
authors.lastname: Do
mesh_terms: D000328:Adult; D000773:Anesthesia, Obstetrical / Q000009:adverse effects*; D000775:Anesthesia, Spinal / Q000009:adverse effects*; D001794:Blood Pressure / Q000502:physiology*; D002585:Cesarean Section; D004809:Ephedrine / Q000627:therapeutic use; D005260:Female; D006339:Heart Rate / Q000502:physiology; D006801:Humans; D007022:Hypotension / Q000453:epidemiology* / Q000209:etiology*; D007431:Intraoperative Complications / Q000453:epidemiology* / Q000209:etiology*; D016015:Logistic Models; D016017:Odds Ratio; D011184:Postoperative Period; D011187:Posture / Q000502:physiology*; D011247:Pregnancy; D012306:Risk; D016683:Supine Position / Q000502:physiology; D014662:Vasoconstrictor Agents / Q000627:therapeutic use
chemical_list: D014662:Vasoconstrictor Agents; D004809:Ephedrine