Increased Pulse Wave Velocity as a Predictor of Intraoperative Hypotension in Hypertensive Patients Undergoing Spinal Anaesthesia.

Objective: To investigate whether intra-operative hypotension could be predicted with pulse wave velocity (PWV) if measured preoperatively.

Study Design: Descriptive analytical study. Place and Duration of the Study: The University Hospital in Turkiye between September 2021 and September 2022.

Methodology: All patients aged 30 years and older, whose physical status was graded as I or II according to the American Society of Anaesthesiologists (ASA) classification, were scheduled for elective lower extremity surgery under spinal anaesthesia (SA). Patients previously diagnosed with hypertension (HT) and/or using antihypertensive medication constituted the HT group, and patients with a preoperative systolic blood pressure (SBP) with a value of <140 mmHg constituted the control group. Arterial stiffness measurements of the patient and control groups were performed using the Oscillo metric device [Mobil-O-Graph]. The SBP and diastolic blood pressure (DBP) values were measured. A 20% or more decrease in systolic blood pressure (SBP) compared to the baseline SBP indicated spinal anaesthesia-related hypotension (SARH).

Results: The PWV was higher in the HT group than the control group (p <0.001). The rates of patients that developed hypotension at the 3rd, 5th, 10th, 20th, and 30th minutes of SA were also higher in the HT group than in the control group (p <0.05). The PWV value was significantly higher in patients with SARH than those without SARH at the 3rd, 5th, 10th, 20th, and 30th minutes after SA (p = 0.001, p = 0.001, p = 0.002, p = 0.001, and p = 0.001, respectively).

Conclusion: Preoperative PWV may be an effective biomarker in predicting spinal anaesthesia-related hypotension in hypertensive patients.

Key Words: Hypotension, Hypertension, Adult, Haemodynamic, Spinal anaesthesia.