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• W2085294586 abstract "Very few publications correlate hypotension in obese pregnant women, and especially morbidly obese, after spinal anesthesia for cesarean section. The objective of the present study was to evaluate the incidence of hypotension according to the BMI. Forty-nine patients with pregestational BMI below 25 kg.m−2 were included in the Eutrophia group, and 51 patients with BMI ≥ 25 kg.m−2 were included in the Overweight group. After spinal anesthesia, blood pressure, volume of crystalloid infused, and dose of vasopressors used until delivery were recorded. A fall in systolic blood pressure below 100 mmHg or 10% reduction of the initial systolic blood pressure (SBP) was considered as hypotension and it was corrected by the administration of vasopressors. Episodes of hypotension were fewer in the Eutrophia group (5.89 ± 0.53 vs. 7.80 ± 0.66, p = 0.027), as well as the amount of crystalloid administered (1,298 ± 413.6 mL vs. 1,539 ± 460.0 mL; p = 0.007), and use of vasopressors (5.87 ± 3.45 bolus vs. 7.70 ± 4.46 bolus; p = 0.023). As for associated diseases, we observed higher incidence of diabetes among obese pregnant women (29.41% vs. 9.76%, RR 1.60, 95%CI: 1.15–2.22, p = 0.036), however, differences in the incidence of pregnancy-induced hypertension (PIH) were not observe between both groups (overweight: 21.57%, normal weight: 12.20%, RR 1.30, 95%CI: 0.88–1.94, p = 0.28). In the study sample, pregestational BMI ≥ 25 kg.m−2 was a risk factor for hypotension after spinal anesthesia in patients undergoing cesarean section. The same group of patients required higher doses of vasopressors. Those results indicate that the anesthetic techniques in those patients should be improved to reduce the consequences of post-spinal anesthesia hypotension, both in pregnant women and fetuses. Existem poucas publicações correlacionando hipotensão em gestantes obesas, principalmente em obesas mórbidas, após raquianestesia para cesárea. Objetivamos avaliar a incidência de hipotensão correlacionada ao IMC. No grupo Eutrofia foram incluídas 49 pacientes com IMC pré-gestacional abaixo de 25 kg.m−2 e no grupo Sobrepeso, 51 pacientes com IMC igual ou acima de 25 kg.m−2. Após raquianestesia, foram anotadas as medidas de pressão arterial, volume de cristaloides infundidos e dose de vasopressores utilizada até o nascimento. Redução da pressão arterial sistólica abaixo de 100 mmHg ou 10% da pressão arterial sistólica (PAS) inicial foi classificada como hipotensão e corrigida com vasopressor. Os episódios de hipotensão foram menores no grupo Eutrofia (5,89 ± 0,53 vs. 7,80 ± 0,66; p = 0,027), assim como a quantidade de cristaloides (1.298 ± 413,6 mL vs. 1.539 ± 460,0 mL; p = 0,007) e o uso de vasopressores (5,87 ± 3,45 bolus vs. 7,70 ± 4,46 bolus; p = 0,023). Quanto às doenças associadas, observamos maior incidência de diabetes entre as gestantes obesas (29,41% vs. 9,76%, RR 1,60; IC 95%: 1,15–2,22; p = 0,036), porém não houve diferença entre os grupos em relação à incidência de doença hipertensiva específica da gestação (DHEG) (sobrepeso: 21,57%, peso normal: 12,20%, RR 1,30; IC 95%: 0,88–1,94; p = 0,28). Na amostra estudada, IMC pré-gestacional maior ou igual a 25 kg.m−2 apresentou-se como fator de risco para hipotensão após raquianestesia em pacientes submetidas a cesáreas. O mesmo grupo de pacientes necessitou de um número de doses maior de vasopressores. A valorização desses achados implica aprimorar as técnicas anestésicas nessas pacientes a fim de diminuir as consequências da hipotensão pós-raquianestesia, tanto na gestante como no feto. Existen pocas publicaciones correlacionando la hipotensión en embarazadas obesas y principalmente obesas mórbidas, después de la raquianestesia para cesárea. Deseamos aquí evaluar la incidencia de la hipotensión correlacionada con el IMC. En el grupo Eutrofia fueron incluidas 49 pacientes con IMC pregestacional por debajo de 25 kg.m−2 y en el grupo Sobrepeso 51 pacientes con IMC igual o por encima de 25 kg.m−2. Después de la raquianestesia fueron anotadas las medidas de presión arterial, volumen de cristaloides infundidos y dosis de vasopresores utilizadas hasta el nacimiento. La reducción de la presión arterial sistólica por debajo de 100 mmHg o 10% de la presión arterial sistólica (PAS) inicial, fue considerado como hipotensión y corregida con vasopresor. Los episodios de hipotensión fueron menores en el grupo Eutrofia (5,89 ± 0,53 vs 7,80 ± 0,66; p 0,027); como también la cantidad de cristaloides (1298 ± 413,6 mL vs. 1539 ± 460,0 mL; p 0,007) y el uso de vasopresores (5,87 ± 3,45 bolo vs. 7,70 ± 4,46 bolo; p 0,023). En lo concerniente a las enfermedades asociadas, observamos una mayor incidencia de diabetes entre las embarazadas obesas (29,41% vs. 9,76%, RR 1,60, IC 95%: 1,15–2,22, p 0,036), pero no hubo una diferencia entre los grupos con relación a la incidencia de enfermedad hipertensiva específica de la gestación (DHEG) (sobrepeso: 21,57%, peso normal: 12,20%, RR 1,30, IC 95%: 0,88–1,94, p 0,28). En la muestra en estudio, el IMC pregestacional mayor o igual a 25 kg.m−2 se presentó como un factor de riesgo para la hipotensión después de la raquianestesia en pacientes sometidas a la cesárea. El mismo grupo de pacientes necesitó un número de dosis mayor de vasopresores. La valoración de esos hallazgos nos hace perfeccionar las técnicas anestésicas en esas pacientes para reducir las consecuencias de la hipotensión postraquianestesia, tanto en la embarazada como en el feto." @default.
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• W2085294586 title "Correlation between the Body Mass Index (BMI) of Pregnant Women and the Development of Hypotension after Spinal Anesthesia for Cesarean Section" @default.
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• W2085294586 doi "https://doi.org/10.1016/s0034-7094(11)70003-4" @default.
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