Spinal anesthesia with hyperbaric bupivacaine: a comparison of hypertensive and normotensive patients

Hypotension is the most common problem with spinal anesthesia. This prospective study aimed to compare normotensive and hypertensive patients with respect to the hemodynamic effects of spinal anesthesia performed with hyperbaric bupivacaine.

Sixty patients who were scheduled to undergo various elective operations under spinal anesthesia were included into the study. The patients were separated into 2 groups: hypertensive patients constituted Group H (n=30) and normotensive patients constituted Group N (n=30). After fluid loading, spinal anesthesia was performed with 3.5 ml 0.5% hyperbaric bupivacaine. Demographic characteristics and incidence of hypotension and bradycardia were compared. Systolic (SBP), diastolic (DBP), and mean blood pressures (MBP) and heart rate (HR) were also compared before and after spinal anesthesia.

There was no significant difference between the groups with respect to demographic characteristics, maximal height of sensory block, incidences of hypotension and bradycardia, and the amount of fluids infused (p>0.05). In the hypertensive patient group, the SBP, DBP, and MBP values were significantly higher than in the normotensive patient group at all measurement times (p<0.05). Comparison within the groups did not reveal any significant differences in either group compared to the basal values (p>0.05). There were no significant differences in HR between or within groups (p>0.05).

There was no significant difference between normotensive and hypertensive patients in the incidences of hypotension caused by spinal anesthesia with 0.5% hyperbaric bupivacaine.