title: Spinal anesthesia with hyperbaric bupivacaine: a comparison of hypertensive and normotensive patients.
abstract: BACKGROUND
  Hypotension is the most common problem with spinal anesthesia. This prospective study aimed to compare normotensive and hypertensive patients with respect to the hemodynamic effects of spinal anesthesia performed with hyperbaric bupivacaine.
  
  
  METHODS
  Sixty patients who were scheduled to undergo various elective operations under spinal anesthesia were included into the study. The patients were separated into 2 groups: hypertensive patients constituted Group H (n=30) and normotensive patients constituted Group N (n=30). After fluid loading, spinal anesthesia was performed with 3.5 ml 0.5% hyperbaric bupivacaine. Demographic characteristics and incidence of hypotension and bradycardia were compared. Systolic (SBP), diastolic (DBP), and mean blood pressures (MBP) and heart rate (HR) were also compared before and after spinal anesthesia.
  
  
  RESULTS
  There was no significant difference between the groups with respect to demographic characteristics, maximal height of sensory block, incidences of hypotension and bradycardia, and the amount of fluids infused (p>0.05). In the hypertensive patient group, the SBP, DBP, and MBP values were significantly higher than in the normotensive patient group at all measurement times (p<0.05). Comparison within the groups did not reveal any significant differences in either group compared to the basal values (p>0.05). There were no significant differences in HR between or within groups (p>0.05).
  
  
  CONCLUSIONS
  There was no significant difference between normotensive and hypertensive patients in the incidences of hypotension caused by spinal anesthesia with 0.5% hyperbaric bupivacaine.
authors.affiliation: Department of Anesthesiology and Reanimation, Sincan State Hospital, Ankara, Turkey.
authors.forename: Nermin Sardogan
authors.initials: NS
authors.lastname: Acar
authors.forename: Sinan
authors.initials: S
authors.lastname: Uzman
authors.forename: Mehmet
authors.initials: M
authors.lastname: Toptas
authors.forename: Ayse
authors.initials: A
authors.lastname: Vahapoglu
authors.forename: Ibrahim
authors.initials: I
authors.lastname: Akkoc
authors.forename: Safiye Cakir
authors.initials: SC
authors.lastname: Dinc
mesh_terms: D000328:Adult; D000775:Anesthesia, Spinal / Q000379:methods*; D001794:Blood Pressure / Q000187:drug effects; D002045:Bupivacaine / Q000009:adverse effects / Q000494:pharmacology*; D017558:Elective Surgical Procedures / Q000379:methods*; D006339:Heart Rate / Q000187:drug effects; D006801:Humans; D006973:Hypertension / Q000503:physiopathology*; D008875:Middle Aged; D011446:Prospective Studies; D018709:Statistics, Nonparametric
chemical_list: D002045:Bupivacaine