ArticleJournal of the Chinese Medical Association : JCMA2024
Risk factors of more severe hypotension after spinal anesthesia for cesarean section.
Article in Journal of the Chinese Medical Association : JCMA, 2024. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 5 papers, 1 of them a synthesis that pooled it.
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Who cites it
5 citing papers in PubMed, 1 synthesis or guideline pooled it, 7 citations in OpenAlex.
- Preoperative patient risk factors for intraoperative hypotension: a systematic review and meta-analysis.Frontiers in cardiovascular medicine · 2025Pooled it
- Prevalence and factors associated with hypotension after spinal anesthesia during cesarean section at public hospitals in Harar town, Eastern Ethiopia.Journal of public health research · 2026Article
- Prediction of spinal anesthesia-induced hypotension during cesarean delivery: a narrative review.Journal of anesthesia, analgesia and critical care · 2026Review
- Effectiveness of lumbar wedge in preventing intraoperative hypotension during cesarean delivery in multiple gestation: a retrospective analysis.BMC pregnancy and childbirth · 2025Observational
- Analysis of the risk difference in post-spinal anesthesia hypotension between primiparas and multiparas in cesarean section.Frontiers in surgery · 2025Article
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Authors and funding
5 authors at 2 institutions in 1 country.
Funding
No grant is acknowledged in the PubMed record.
Abstract
backgroundThe aim of this study was to examine the risk factors associated with the use of vasopressors to prevent hypotension that occurs after spinal anesthesia during cesarean section. Although the prophylactic use of vasopressors is already suggested as routine care in many parts of the world, the occurrence of spinal anesthesia-induced hypotension (SAIH) is still common in parturients.
methodsThis retrospective study included parturients receiving elective cesarean deliveries under spinal anesthesia from April 2016 to March 2020. Risk factors related to ephedrine dosage were analyzed using a hurdle model, and risk factors related to SAIH were further analyzed with logistic regression.
resultsFive risk factors, namely maternal body mass index (BMI, p < 0.001), baseline systolic blood pressure (SBP, p < 0.001), baseline heart rate (HR, p = 0.047), multiparity ( p = 0.003), and large fetal weight ( p = 0.005) were significantly associated with the requirement for ephedrine. Furthermore, a higher ephedrine dosage was significantly associated with maternal BMI ( p < 0.001), baseline SBP ( p < 0.001), baseline HR ( p < 0.001), multiparity ( p = 0.027), large fetal weight ( p = 0.030), maternal age ( p = 0.009), and twin pregnancies ( p < 0.001). Logistic regression analysis also showed that the same five risk factors-maternal BMI ( p = 0.030), baseline SBP ( p < 0.001), baseline HR ( p < 0.001), multiparity ( p < 0.001), and large fetal weight ( p < 0.001)-were significantly associated with SAIH, even in cases where vasopressors were administered.
conclusionThese findings can be useful for clinicians when deciding the dose of prophylactic ephedrine or phenylephrine to prevent SAIH.
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