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Abstract
Cardiovascular responses to supine inferior vena cava compression might predict hypotension
risk during elective cesarean delivery using spinal anesthesia. In this pilot study
we investigated 27 women before operation by taking blood pressure and heart rate
measurements for 5 min in the left lateral position, 5 min supine, and then performed
one further reading in the left lateral position and one sitting. Anesthesia with
hyperbaric bupivacaine was rigorously standardised. A pre-operative ‘supine stress
test’, combining an increase in maternal heart rate of greater than 10 beats/min or
leg flexion movements while supine, was analysed. A positive supine stress test (SST)
was 4.1 times more frequent in those with severe systolic hypotension below 70% of
baseline (12 out of 16 women) than in those without (2 out of 11 women), with a sensitivity
of 75% (95% C.I. 48% to 93%) and specificity of 82% (95% C.I. 48% to 98%). A positive
test was associated with twice as much vasopressor use as a negative test (![Math Eq]()
mg versus ![Math Eq]()
mg; P = 0.0014). Unlike the SST, cardiovascular responses to the change from recumbent
to sitting (tilt test) were not useful as a predictor of hypotension.
mg versus 
mg; P = 0.0014). Unlike the SST, cardiovascular responses to the change from recumbent
to sitting (tilt test) were not useful as a predictor of hypotension.To read this article in full you will need to make a payment
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References
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© 1996 Published by Elsevier Inc.
