Predictive effect of the difference of brachial artery peak velocity in different positions on Supine hypo-tension syndrome of parturient after spinal anesthesia
10.12089/jca.2018.04.007
- VernacularTitle:不同体位肱动脉峰流速差值对产妇腰麻后仰卧位低血压综合征的预测作用
- Author:
Min QU
1
;
Lili YU
;
Jing LI
;
Xiuqing ZHANG
;
Tianlin LIU
;
Yulin CHANG
Author Information
1. 061001,河北省沧州市中心医院麻醉二科
- Keywords:
Parturient;
Position;
Brachial artery peak velocity;
Supine hypotension syndrome
- From:
The Journal of Clinical Anesthesiology
2018;34(4):345-347
- CountryChina
- Language:Chinese
-
Abstract:
Objective To investigate the effectiveness of predicting the incidence of supine hy-potension syndrome (SHS)after spinal anesthesia measured by ultrasonic measurement of the varia-tion of brachial artery peak velocity in different positions of parturient.Methods Parturient scheduled for elective cesarean section,ASA physical status Ⅰ or Ⅱ,were divided into SHS group and no-SHS group (SBP in the upper extremity decreased by > 30 mm Hg or decreased to < 80 mm Hg)after spinal anesthesia.HR,SBP,DBP of supine position and left lateral position before anesthesia were re-corded,and brachial artery peak velocity were measured by Ultrasonic.The differences of the above indexs before and after the transformation position were calculated.The receiver operating characteris-tic curve (ROC)was plotted by indexs of which P values were less than 0.05,to evaluate the predic-tive effect of each index on SHS after spinal anesthesia.Results Among the 196 patients,89 cases (45.4%)developed SHS after spinal anesthesia.SBP,DBP,peak velocity of brachial artery (Vpmin) and brachial artery peak velocity variation (ΔVp)were different before and after the transformation position (P<0.05).The difference in SHS group was significantly higher than no-SHS group.The areas under ROC curve (AUC)of ΔSBP,ΔDBP,ΔVpmin,ΔΔVp were 0.711 (95%CI 0.575-0.846), 0.573 (95%CI 0.419-0.727),0.948 (95% CI 0.895-0.987),0.864 (95% CI 0.770-0.958),and the cut-off values were 17.5 mm Hg,7.6 mm Hg,17.8 cm/s,and 13.1%.Conclusion The differ-ence of brachial artery peak velocity measured by ultrasonic in different positions of parturient can ef-fectively predict the occurrence of SHS,in which ΔVpmin≥ 17.8 cm/s has better predictive effect.
