Changes in the corrected carotid flow time can predict spinal anesthesia-induced hypotension in patients undergoing cesarean delivery: an observational study
Purpose Spinal anesthesia is a standard technique for cesarean delivery; however, it possesses a risk of hypotension. We hypothesised that the changes in the corrected flow time induced by the Trendelenburg position could predict the incidence of hypotension after spinal anesthesia for cesarean deli...
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| Veröffentlicht in: | Journal of anesthesia 2024-02, Vol.38 (1), p.105-113 |
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| creator | Juri, Takashi Suehiro, Koichi Yasuda, Shinta Kimura, Aya Fujimoto, Yohei Mori, Takashi |
| description | Purpose
Spinal anesthesia is a standard technique for cesarean delivery; however, it possesses a risk of hypotension. We hypothesised that the changes in the corrected flow time induced by the Trendelenburg position could predict the incidence of hypotension after spinal anesthesia for cesarean delivery.
Methods
Patients undergoing elective cesarean delivery under spinal anesthesia were enrolled. Before anesthesia induction, corrected flow time was measured in the supine and Trendelenburg positions (FTc-1 and FTc-2, respectively). Additionally, a percent change in corrected flow time induced by the Trendelenburg position was defined as ΔFTc. The primary endpoint was to investigate the ability of ΔFTc to predict the incidence of spinal anesthesia-induced hypotension until delivery. The receiver operating characteristics curves to assess the ability of FTc-1, FTc-2, and ΔFTc to predict the incidence of hypotension were generated.
Results
Finally, 40 patients were included, and of those, 26 (65%) developed spinal anesthesia-induced hypotension. The areas under the curve for FTc-1, FTc-2, and ΔFTc were 0.591 (95% CI: 0.424 to 0.743) (P = 0.380), 0.742 (95% CI: 0.579 to 0.867) (P = 0.004), and 0.882 (95% CI: 0.740 to 0.962) (P |
| doi_str_mv | 10.1007/s00540-023-03293-2 |
| format | Article |
| fullrecord | <record><control><sourceid>proquest_cross</sourceid><recordid>TN_cdi_proquest_miscellaneous_2910191463</recordid><sourceformat>XML</sourceformat><sourcesystem>PC</sourcesystem><sourcerecordid>2910191463</sourcerecordid><originalsourceid>FETCH-LOGICAL-c374t-6ff7a6cabd4531b070dd40cef1674ec75f7a3cb89cac0c9739480ca8901341693</originalsourceid><addsrcrecordid>eNp9kb2O1DAUhS0EYmcXXoACuaQxXMeZJKZDI35WWokGasuxb2a8ytjB11k0D8O74mEWSioX55xPuv4YeyXhrQTo3xHAtgUBjRKgGq1E84RtZKsGMaitfso2oKUSQ9cNV-ya6B4AOinVc3alBtk3jW427NfuYOMeiYfIywG5SzmjK-i5szmV4Pk0p5-8hGPNbORLRh9c4bSEaGduI1KdUbAiRL-6ujucllQwUkjxDF1sCRgL8TV6zPsU4p47JJux0jzO4QHz6X0F8TQS5odaT2cyldWfXrBnk50JXz6-N-z7p4_fdl_E3dfPt7sPd8Kpvi2im6beds6Ovt0qOUIP3rfgcJJd36LrtzVWbhy0sw6c7pVuB3B20CBVKzutbtibC3fJ6cdaTzLHQA7nud6XVjKNliC1bDtVq82l6nIiyjiZJYejzScjwZy1mIsWU7WYP1pMU0evH_nreET_b_LXQy2oS4FqVH1kc5_WXP-B_of9DaUPnHw</addsrcrecordid><sourcetype>Aggregation Database</sourcetype><iscdi>true</iscdi><recordtype>article</recordtype><pqid>2910191463</pqid></control><display><type>article</type><title>Changes in the corrected carotid flow time can predict spinal anesthesia-induced hypotension in patients undergoing cesarean delivery: an observational study</title><source>MEDLINE</source><source>SpringerLink Journals</source><creator>Juri, Takashi ; Suehiro, Koichi ; Yasuda, Shinta ; Kimura, Aya ; Fujimoto, Yohei ; Mori, Takashi</creator><creatorcontrib>Juri, Takashi ; Suehiro, Koichi ; Yasuda, Shinta ; Kimura, Aya ; Fujimoto, Yohei ; Mori, Takashi</creatorcontrib><description>Purpose
Spinal anesthesia is a standard technique for cesarean delivery; however, it possesses a risk of hypotension. We hypothesised that the changes in the corrected flow time induced by the Trendelenburg position could predict the incidence of hypotension after spinal anesthesia for cesarean delivery.
Methods
Patients undergoing elective cesarean delivery under spinal anesthesia were enrolled. Before anesthesia induction, corrected flow time was measured in the supine and Trendelenburg positions (FTc-1 and FTc-2, respectively). Additionally, a percent change in corrected flow time induced by the Trendelenburg position was defined as ΔFTc. The primary endpoint was to investigate the ability of ΔFTc to predict the incidence of spinal anesthesia-induced hypotension until delivery. The receiver operating characteristics curves to assess the ability of FTc-1, FTc-2, and ΔFTc to predict the incidence of hypotension were generated.
Results
Finally, 40 patients were included, and of those, 26 (65%) developed spinal anesthesia-induced hypotension. The areas under the curve for FTc-1, FTc-2, and ΔFTc were 0.591 (95% CI: 0.424 to 0.743) (P = 0.380), 0.742 (95% CI: 0.579 to 0.867) (P = 0.004), and 0.882 (95% CI: 0.740 to 0.962) (P < 0.001) respectively, indicating ΔFTc as the best predictor among these three parameters. The best threshold for ΔFTc was 6.4% (sensitivity: 80.8% (95% CI: 53.8 to 96.2), specificity: 85.7% (95% CI: 42.9 to 100.0)).
Conclusions
This study demonstrated that changes in the corrected carotid flow time induced by the Trendelenburg position could serve as a good predictor of spinal anesthesia-induced hypotension for cesarean delivery.</description><identifier>ISSN: 0913-8668</identifier><identifier>ISSN: 1438-8359</identifier><identifier>EISSN: 1438-8359</identifier><identifier>DOI: 10.1007/s00540-023-03293-2</identifier><identifier>PMID: 38172292</identifier><language>eng</language><publisher>Singapore: Springer Nature Singapore</publisher><subject>Anesthesia, Obstetrical - adverse effects ; Anesthesia, Spinal - methods ; Anesthesiology ; Critical Care Medicine ; Emergency Medicine ; Female ; Humans ; Hypotension - etiology ; Hypotension, Controlled ; Intensive ; Medicine ; Medicine & Public Health ; Original Article ; Pain Medicine ; Patient Positioning - adverse effects ; Pregnancy</subject><ispartof>Journal of anesthesia, 2024-02, Vol.38 (1), p.105-113</ispartof><rights>The Author(s) under exclusive licence to Japanese Society of Anesthesiologists 2024. Springer Nature or its licensor (e.g. a society or other partner) holds exclusive rights to this article under a publishing agreement with the author(s) or other rightsholder(s); author self-archiving of the accepted manuscript version of this article is solely governed by the terms of such publishing agreement and applicable law.</rights><rights>2024. The Author(s) under exclusive licence to Japanese Society of Anesthesiologists.</rights><lds50>peer_reviewed</lds50><woscitedreferencessubscribed>false</woscitedreferencessubscribed><citedby>FETCH-LOGICAL-c374t-6ff7a6cabd4531b070dd40cef1674ec75f7a3cb89cac0c9739480ca8901341693</citedby><cites>FETCH-LOGICAL-c374t-6ff7a6cabd4531b070dd40cef1674ec75f7a3cb89cac0c9739480ca8901341693</cites><orcidid>0000-0002-2156-6092</orcidid></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><linktopdf>$$Uhttps://link.springer.com/content/pdf/10.1007/s00540-023-03293-2$$EPDF$$P50$$Gspringer$$H</linktopdf><linktohtml>$$Uhttps://link.springer.com/10.1007/s00540-023-03293-2$$EHTML$$P50$$Gspringer$$H</linktohtml><link.rule.ids>314,776,780,27901,27902,41464,42533,51294</link.rule.ids><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/38172292$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><creatorcontrib>Juri, Takashi</creatorcontrib><creatorcontrib>Suehiro, Koichi</creatorcontrib><creatorcontrib>Yasuda, Shinta</creatorcontrib><creatorcontrib>Kimura, Aya</creatorcontrib><creatorcontrib>Fujimoto, Yohei</creatorcontrib><creatorcontrib>Mori, Takashi</creatorcontrib><title>Changes in the corrected carotid flow time can predict spinal anesthesia-induced hypotension in patients undergoing cesarean delivery: an observational study</title><title>Journal of anesthesia</title><addtitle>J Anesth</addtitle><addtitle>J Anesth</addtitle><description>Purpose
Spinal anesthesia is a standard technique for cesarean delivery; however, it possesses a risk of hypotension. We hypothesised that the changes in the corrected flow time induced by the Trendelenburg position could predict the incidence of hypotension after spinal anesthesia for cesarean delivery.
Methods
Patients undergoing elective cesarean delivery under spinal anesthesia were enrolled. Before anesthesia induction, corrected flow time was measured in the supine and Trendelenburg positions (FTc-1 and FTc-2, respectively). Additionally, a percent change in corrected flow time induced by the Trendelenburg position was defined as ΔFTc. The primary endpoint was to investigate the ability of ΔFTc to predict the incidence of spinal anesthesia-induced hypotension until delivery. The receiver operating characteristics curves to assess the ability of FTc-1, FTc-2, and ΔFTc to predict the incidence of hypotension were generated.
Results
Finally, 40 patients were included, and of those, 26 (65%) developed spinal anesthesia-induced hypotension. The areas under the curve for FTc-1, FTc-2, and ΔFTc were 0.591 (95% CI: 0.424 to 0.743) (P = 0.380), 0.742 (95% CI: 0.579 to 0.867) (P = 0.004), and 0.882 (95% CI: 0.740 to 0.962) (P < 0.001) respectively, indicating ΔFTc as the best predictor among these three parameters. The best threshold for ΔFTc was 6.4% (sensitivity: 80.8% (95% CI: 53.8 to 96.2), specificity: 85.7% (95% CI: 42.9 to 100.0)).
Conclusions
This study demonstrated that changes in the corrected carotid flow time induced by the Trendelenburg position could serve as a good predictor of spinal anesthesia-induced hypotension for cesarean delivery.</description><subject>Anesthesia, Obstetrical - adverse effects</subject><subject>Anesthesia, Spinal - methods</subject><subject>Anesthesiology</subject><subject>Critical Care Medicine</subject><subject>Emergency Medicine</subject><subject>Female</subject><subject>Humans</subject><subject>Hypotension - etiology</subject><subject>Hypotension, Controlled</subject><subject>Intensive</subject><subject>Medicine</subject><subject>Medicine & Public Health</subject><subject>Original Article</subject><subject>Pain Medicine</subject><subject>Patient Positioning - adverse effects</subject><subject>Pregnancy</subject><issn>0913-8668</issn><issn>1438-8359</issn><issn>1438-8359</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2024</creationdate><recordtype>article</recordtype><sourceid>EIF</sourceid><recordid>eNp9kb2O1DAUhS0EYmcXXoACuaQxXMeZJKZDI35WWokGasuxb2a8ytjB11k0D8O74mEWSioX55xPuv4YeyXhrQTo3xHAtgUBjRKgGq1E84RtZKsGMaitfso2oKUSQ9cNV-ya6B4AOinVc3alBtk3jW427NfuYOMeiYfIywG5SzmjK-i5szmV4Pk0p5-8hGPNbORLRh9c4bSEaGduI1KdUbAiRL-6ujucllQwUkjxDF1sCRgL8TV6zPsU4p47JJux0jzO4QHz6X0F8TQS5odaT2cyldWfXrBnk50JXz6-N-z7p4_fdl_E3dfPt7sPd8Kpvi2im6beds6Ovt0qOUIP3rfgcJJd36LrtzVWbhy0sw6c7pVuB3B20CBVKzutbtibC3fJ6cdaTzLHQA7nud6XVjKNliC1bDtVq82l6nIiyjiZJYejzScjwZy1mIsWU7WYP1pMU0evH_nreET_b_LXQy2oS4FqVH1kc5_WXP-B_of9DaUPnHw</recordid><startdate>20240201</startdate><enddate>20240201</enddate><creator>Juri, Takashi</creator><creator>Suehiro, Koichi</creator><creator>Yasuda, Shinta</creator><creator>Kimura, Aya</creator><creator>Fujimoto, Yohei</creator><creator>Mori, Takashi</creator><general>Springer Nature Singapore</general><scope>CGR</scope><scope>CUY</scope><scope>CVF</scope><scope>ECM</scope><scope>EIF</scope><scope>NPM</scope><scope>AAYXX</scope><scope>CITATION</scope><scope>7X8</scope><orcidid>https://orcid.org/0000-0002-2156-6092</orcidid></search><sort><creationdate>20240201</creationdate><title>Changes in the corrected carotid flow time can predict spinal anesthesia-induced hypotension in patients undergoing cesarean delivery: an observational study</title><author>Juri, Takashi ; Suehiro, Koichi ; Yasuda, Shinta ; Kimura, Aya ; Fujimoto, Yohei ; Mori, Takashi</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-c374t-6ff7a6cabd4531b070dd40cef1674ec75f7a3cb89cac0c9739480ca8901341693</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2024</creationdate><topic>Anesthesia, Obstetrical - adverse effects</topic><topic>Anesthesia, Spinal - methods</topic><topic>Anesthesiology</topic><topic>Critical Care Medicine</topic><topic>Emergency Medicine</topic><topic>Female</topic><topic>Humans</topic><topic>Hypotension - etiology</topic><topic>Hypotension, Controlled</topic><topic>Intensive</topic><topic>Medicine</topic><topic>Medicine & Public Health</topic><topic>Original Article</topic><topic>Pain Medicine</topic><topic>Patient Positioning - adverse effects</topic><topic>Pregnancy</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>Juri, Takashi</creatorcontrib><creatorcontrib>Suehiro, Koichi</creatorcontrib><creatorcontrib>Yasuda, Shinta</creatorcontrib><creatorcontrib>Kimura, Aya</creatorcontrib><creatorcontrib>Fujimoto, Yohei</creatorcontrib><creatorcontrib>Mori, Takashi</creatorcontrib><collection>Medline</collection><collection>MEDLINE</collection><collection>MEDLINE (Ovid)</collection><collection>MEDLINE</collection><collection>MEDLINE</collection><collection>PubMed</collection><collection>CrossRef</collection><collection>MEDLINE - Academic</collection><jtitle>Journal of anesthesia</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>Juri, Takashi</au><au>Suehiro, Koichi</au><au>Yasuda, Shinta</au><au>Kimura, Aya</au><au>Fujimoto, Yohei</au><au>Mori, Takashi</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>Changes in the corrected carotid flow time can predict spinal anesthesia-induced hypotension in patients undergoing cesarean delivery: an observational study</atitle><jtitle>Journal of anesthesia</jtitle><stitle>J Anesth</stitle><addtitle>J Anesth</addtitle><date>2024-02-01</date><risdate>2024</risdate><volume>38</volume><issue>1</issue><spage>105</spage><epage>113</epage><pages>105-113</pages><issn>0913-8668</issn><issn>1438-8359</issn><eissn>1438-8359</eissn><abstract>Purpose
Spinal anesthesia is a standard technique for cesarean delivery; however, it possesses a risk of hypotension. We hypothesised that the changes in the corrected flow time induced by the Trendelenburg position could predict the incidence of hypotension after spinal anesthesia for cesarean delivery.
Methods
Patients undergoing elective cesarean delivery under spinal anesthesia were enrolled. Before anesthesia induction, corrected flow time was measured in the supine and Trendelenburg positions (FTc-1 and FTc-2, respectively). Additionally, a percent change in corrected flow time induced by the Trendelenburg position was defined as ΔFTc. The primary endpoint was to investigate the ability of ΔFTc to predict the incidence of spinal anesthesia-induced hypotension until delivery. The receiver operating characteristics curves to assess the ability of FTc-1, FTc-2, and ΔFTc to predict the incidence of hypotension were generated.
Results
Finally, 40 patients were included, and of those, 26 (65%) developed spinal anesthesia-induced hypotension. The areas under the curve for FTc-1, FTc-2, and ΔFTc were 0.591 (95% CI: 0.424 to 0.743) (P = 0.380), 0.742 (95% CI: 0.579 to 0.867) (P = 0.004), and 0.882 (95% CI: 0.740 to 0.962) (P < 0.001) respectively, indicating ΔFTc as the best predictor among these three parameters. The best threshold for ΔFTc was 6.4% (sensitivity: 80.8% (95% CI: 53.8 to 96.2), specificity: 85.7% (95% CI: 42.9 to 100.0)).
Conclusions
This study demonstrated that changes in the corrected carotid flow time induced by the Trendelenburg position could serve as a good predictor of spinal anesthesia-induced hypotension for cesarean delivery.</abstract><cop>Singapore</cop><pub>Springer Nature Singapore</pub><pmid>38172292</pmid><doi>10.1007/s00540-023-03293-2</doi><tpages>9</tpages><orcidid>https://orcid.org/0000-0002-2156-6092</orcidid></addata></record> |
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| ispartof | Journal of anesthesia, 2024-02, Vol.38 (1), p.105-113 |
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| subjects | Anesthesia, Obstetrical - adverse effects Anesthesia, Spinal - methods Anesthesiology Critical Care Medicine Emergency Medicine Female Humans Hypotension - etiology Hypotension, Controlled Intensive Medicine Medicine & Public Health Original Article Pain Medicine Patient Positioning - adverse effects Pregnancy |
| title | Changes in the corrected carotid flow time can predict spinal anesthesia-induced hypotension in patients undergoing cesarean delivery: an observational study |
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