A comparison of hypotension and bradycardia following spinal anesthesia in patients on calcium channel blockers and β-blockers

Objectives: Hypotension is a common complication of spinal anesthesia and is frequent in patients with hypertension. Antihypertensive agents decrease this effect by controlling blood pressure. There are conflicting reports on the continuation of antihypertensive drugs on the day of surgery in patients undergoing spinal anesthesia. Sudden hypotension could have detrimental effect on the organ systems. This study was undertaken to compare the variation in blood pressure in hypertensive patients on β-blockers and calcium channel blockers undergoing spinal anesthesia. Materials and Methods: Ninety patients were enrolled for the study, 30 each in the control, β-blocker and the calcium channel blocker groups. Results: The incidence of hypotension was not different among the three groups. However, the number of times mephentermine used to treat hypotension was significant in the patients receiving calcium channel blockers while incidence of bradycardia in patients treated with β-blockers was significant (P<0.001). Conclusion: The incidence of hypotension following spinal anesthesia is not different in patients receiving β-blockers and calcium channel blockers among the three groups.

[1]  David L. Brown.  Spinal, Epidural, and Caudal Anesthesia , 2010 .

[2]  K. Samad,et al.  Hemodynamic effects of anesthetic induction in patients treated with beta and calcium channel blockers. , 2008, Middle East journal of anaesthesiology.

[3]  Mamta,et al.  Risk factors for development of early hypotension during spinal anaesthesia , 2006 .

[4]  Cozanitis Da.  The importance of interrupting angiotensin converting enzyme inhibitor treatment before spinal anaesthesia--a controlled case report. , 2004 .

[5]  D. Cozanitis.  The importance of interrupting angiotensin converting enzyme inhibitor treatment before spinal anaesthesia--a controlled case report. , 2004, Anaesthesiologie und Reanimation.

[6]  W. Boemke,et al.  ACE inhibition does not exaggerate the blood pressure decrease in the early phase of spinal anaesthesia , 2003, Acta anaesthesiologica Scandinavica.

[7]  Axel Junger,et al.  The incidence and risk factors for hypotension after spinal anesthesia induction: an analysis with automated data collection. , 2002, Anesthesia and analgesia.

[8]  J. Pollard.  Cardiac Arrest During Spinal Anesthesia: Common Mechanisms and Strategies for Prevention , 2001, Anesthesia and analgesia.

[9]  G. A. Rooke,et al.  Hemodynamic Response and Change in Organ Blood Volume During Spinal Anesthesia in Elderly Men with Cardiac Disease , 1997, Anesthesia and analgesia.

[10]  J. Sear,et al.  Does the choice of antihypertensive therapy influence haemodynamic responses to induction, laryngoscopy and intubation? , 1995, British journal of anaesthesia.

[11]  P. Coriat,et al.  Influence of Chronic Angiotensin‐converting Enzyme Inhibition on Anesthetic Induction , 1994, Anesthesiology.

[12]  J. Pontén,et al.  β‐Receptor Blockade and Spinal Anaesthesia. Withdrawal versus Continuation of Long‐term Therapy , 1982 .

[13]  J. Pontén,et al.  Beta-receptor blockade and spinal anaesthesia. Withdrawal versus continuation of long-term therapy. , 1982, Acta anaesthesiologica Scandinavica. Supplementum.