Reporting of 'hypotension' after epidural analgesia during labour. Effect of choice of arm and timing of baseline readings

Anaesthesia
S M Kinsella, A M Black

Abstract

We studied 20 women in labour to see how reporting 'hypotension' after obstetric epidural analgesia is affected by position of the blood pressure cuff and baseline definition. Blood pressure was recorded from both arms simultaneously while the woman was semirecumbent and then in the left lateral position. Three readings were then taken after epidural bupivacaine, one left lateral and the remainder right lateral. Before the epidural, blood pressure in the dependent arm in the lateral position was similar to blood pressure in either arm in the semirecumbent position and an average of 10 mmHg (systolic) and 14 mmHg (diastolic) higher than blood pressure in the uppermost arm (p < or = 0.00005). This difference persisted in both lateral positions as epidural analgesia became established. Choosing different definitions of hypotension, baselines and arm to measure blood pressure resulted in 'hypotension rates' between 0% and 75%. For blood pressure measurement in the lateral position, the blood pressure cuff should be placed on the dependent arm.

References

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Citations

Jun 2, 2009·International Journal of Gynaecology and Obstetrics : the Official Organ of the International Federation of Gynaecology and Obstetrics·Daniel W SkupskiKlaus Kjaer
May 14, 1998·American Journal of Obstetrics and Gynecology·S M Kinsella
Dec 6, 2003·The Journal of Perinatal & Neonatal Nursing·Judith H Poole
Nov 9, 2017·Current Protocols in Toxicology·Lucio G Costa

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