ESRA Academy. Poredos P. Sep 8, 2016; 138224; 0041 Topic: Physiology - Pathophysiology
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Dr. Peter Poredos
Dr. Peter Poredos

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Background and Aims:

A higher level of spinal anesthesia is complicated by higher incidence of hypotension, bradycardia and nausea. The aim of our study was to determine the incidence of hypotension during spinal anaesthesia in young, healthy patients and to find the difference in haemodynamic variables between the group with high and the group with low spinal block.


In prospective, randomized study 44 ASA 1 patients scheduled for knee arthroscopy under spinal anaesthesia were distributed to high and low spinal block group. In group H patients were placed into horizontal, whereas in group L in 15-degree anti-Trendelenburg position after the spinal block. Haemodynamic parameters were measured continuously noninvasively using CNAPTM device with the LiDCORapid monitor.


The differences in haemodynamic parameters between the groups were not statistically significant at all measured times despite a significant difference in the spinal block level (18.5 vs 13.3 dermatomes above S5, p<0.001) and a significant difference in haemodynamic variables inside each group compared to the baseline value. A significant correlation between CI and stroke volume index (SVI) was found (β=0.849, p<0.001) and also between CI and heart rate (HR) (β=0.573, p<0.001). In group H the incidence of hypotension was 35%, whereas in group L it was 10%, however the differences were not significant.


In our study it was found that in young, healthy patients there are no significant differences in haemodynamic parameters and in incidence of hypotension between high and low spinal block. However, a trend towards less hypotension and bradycardia in a low spinal block was noted.

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