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Arm and ankle blood pressure during caesarean section
S Sanghera1, A North, S Abernethy
1Department of Anaesthesia, Jessop Wing, Royal Hallamshire Hospital, Sheffield, UK.
International Journal of Obstetric Anesthesia
|November 1, 2005
Summary
Ankle blood pressure measurement is unreliable during caesarean sections. This study found ankle measurements often failed to detect significant blood pressure drops seen in the arm, making it unsuitable for monitoring during surgery.
Area of Science:
- Anesthesiology
- Cardiovascular Physiology
Background:
- Non-invasive blood pressure monitoring during caesarean sections under spinal anaesthesia has a high failure rate (>50%).
- The ankle's immobility during caesarean section presents a potential alternative site for blood pressure measurement to improve accuracy.
Purpose of the Study:
- To determine the equivalence of blood pressure measurements taken at the ankle compared to the arm during caesarean sections.
Main Methods:
- 30 women undergoing elective caesarean section provided informed consent.
- Non-invasive blood pressure cuffs were simultaneously placed on the upper arm and ankle.
- Blood pressure was measured at three intervals: pre-spinal, pre-surgery, and post-neonate delivery.
Main Results:
- Bland and Altman analysis revealed only marginal agreement between arm and ankle blood pressure measurements.
- Ankle measurements failed to detect a >20% fall in systolic blood pressure in 8 out of 15 instances where it was evident in the arm.
Conclusions:
- Blood pressure measurement at the ankle is not recommended during caesarean sections due to significant discrepancies.
- The findings highlight the unreliability of ankle-based monitoring in this clinical setting.
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