Hemodynamic stability during menstrual cycle in women undergoing elective surgery

Area of Science:

• Anesthesiology
• Gynecology
• Cardiovascular Physiology

Background:

• Spinal anesthesia can induce significant hemodynamic alterations, potentially impacting vital organ perfusion.
• Understanding these changes in relation to the female reproductive cycle is essential for optimizing anesthetic management.

Purpose of the Study:

• To investigate the hemodynamic effects of spinal anesthesia across different phases of the menstrual cycle.
• To compare the variations in blood pressure and heart rate during spinal anesthesia in the follicular versus luteal phases.

Main Methods:

• A descriptive, cross-sectional study involving 273 patients undergoing elective surgery with spinal anesthesia.
• Patients were categorized into follicular (132) or luteal (141) phases of their menstrual cycle.
• Blood pressure and heart rate were recorded before, immediately after, and 1 hour post-anesthesia.

Main Results:

• Significant hemodynamic changes (systolic blood pressure, diastolic blood pressure, heart rate) were observed immediately after spinal anesthesia in both phases (P < 0.001).
• One hour post-anesthesia, mean arterial pressure and heart rate remained significantly lower in the follicular phase compared to the luteal phase (P < 0.001).
• The luteal phase demonstrated less pronounced variations in hemodynamic parameters compared to the follicular phase.

Conclusions:

• Spinal anesthesia elicits notable hemodynamic changes, with greater variability observed during the follicular phase.
• Patients in the luteal phase experience comparatively less fluctuation in hemodynamic parameters following spinal anesthesia.
• Anesthetic management may need to consider the phase of the menstrual cycle to mitigate hemodynamic instability.