Original Research Article
Year: 2016 | Month: October | Volume: 3 | Issue: 10 | Pages: 57-61
Effect of Chronic β-Blocker Therapy on Hemodynamic Changes Associated With Spinal Subarachnoid Block (A Comparison between Normotensive V/S Controlled Hypertensive Patients β-Blocker Therapy)
Dr Sunita Meena1, Dr Jeetam Singh Meena2, Dr Vinay Joshi3
1Assistant Professor, Department Anaesthesia, SMS Medical College, Jaipur, Rajasthan, India.
2Assistant Professor, Department Paediatrics Medicine, SMS Medical College, Jaipur, Rajasthan, India.
3Formerly Professor, Department of Anaesthesia, S. N Medical College, Jodhpur, Rajasthan, India.
Corresponding Author: Dr Sunita Meena
Background: Beta- receptor blocking drugs are now increasingly used in treatment of hypertension. This prospective, randomized study aimed to compare the magnitude and severity of haemodynamic changes after subarachnoid block (with hyperbaric bupivacaine) between normotensive and controlled hypertensive patients on beta blocker therapy.
Materials and Methods: In the study included total 80 patients underwent for infra umbilical surgery in subarachnoid block. The patients were divided in two groups (40 in each group): Patients controlled hypertensive on beta blocker and normotensive without any medication. After fluid preloading, spinal an aesthesia was performed with hyperbaric bupivacaine (0.5%) 3ml (15 mg). Demographic characteristics and haemodynamic changes, requirement of vasopressor &other side effects were compared. Systolic (SBP), diastolic (DBP) and mean blood pressures (MBP) AND heart rate (HR) were also compared before and after spinal an aesthesia.
Results: There was no significant difference between the groups with demographical and characteristics of spinal an aesthesia (onset, height of sensory analgesia, degree of motor blockade). In controlled hypertensive patients group incidence and magnitude of hypotension, bradycardia, requirement of vasopressor, major side effects nausea & vomiting were higher than as compared to hypertensive group(p<0.05).
Conclusions: Chronic beta blocker therapy for treatment of hypertension or IHD might be responsible for greater magnitude of fall in SBP, DBP, MAP associated spinal subarachnoid block and also required repeated and higher doses of vasopressors.
Key words: Spinal Anaesthesia, Hypertension, Hypotension, Hyperbaric bupivacaine.[PDF Full Text]