Introduction/Objective. Despite frequent side effects such as hypotension,
spinal anesthesia (SA) is still one of the best anesthetic methods for
elective cesarean section (CS). Intermittent, oscillometric, non-invasive
blood pressure monitoring (NIBP) frequently leads to the missed hypotensive
episodes. Our goal was to compare continuous non-invasive arterial pressure
(CNAP) monitoring with NIBP in the terms of efficiency to detect
hypotension. Methods. In this study, we compared CNAP and NIBP monitoring
for hypotension detection in 76 patients divided into two groups of 38
patients treated with ephedrine (E) or phenylephrine (P), during 3 min
intervals, starting from SA, by the end of the surgery. Results. In group
E, significantly lower mean systolic blood pressure (SBP) values with CNAP
compared with NIBP (p = 0.008) was detected. CNAP detected 31 (81.6%)
hypotensive patients in E group and significantly lower number 20 (52.6%)
with NIBP (p = 0.001), while in P group CNAP detected 34 patients (89.5%)
and NIBP, only 18 (47.3%), p = 0.001. CNAP detected significantly higher
number of hypotensive intervals in E and P groups (p < 0.001). Umbilical
vein pH was lower within hypotensive compared with normotensive patients in
E and P groups, with CNAP and NIBP, respectively (p < 0.001, p = 0.027 in E,
and p = 0.009, p < 0.001, in P group). Conclusion. CNAP is much more
efficient in hypotension detection for CS during SA, which allows faster
treatment of hypotension, thus improving fetal and maternal outcome.
Performance of the Hypotension Prediction Index with non-invasive arterial pressure waveforms in non-cardiac surgical patients
