Retrospective evaluation of methods to prevent maternal hypotension and nausea in caesarean operations using spinal anesthesia

Objective: We aimed to examine the causes of hypotension and nausea and vomiting that occur due to spinal anesthesia applications in cesarean section operations, and to compare the effects and success rates of preventive and therapeutic methods on the mother and baby. Method: A total of 348 ASA II patients who underwent elective or emergency cesarean section under performing spinal anesthesia at Akdeniz University Hospital, Department of Anesthesiology and Reanimation, between January 2021 and June 2023, were included in the study. Systolic blood pressure (SBP), diastolic blood pressure (DBP), heart rate (HR), peripheral oxygen saturation (SpO2) were measured and recorded just before and after spinal anesthesia throughout the operation. In addition, age, weight, height, medications and fluids used, blood and blood products, ECG, operation time, 1st and 5th minute Apgar scores are recorded on anesthesia patient follow-up forms. Anesthesia follow-up forms of cesarean section operations of patients who underwent spinal anesthesia were retrospectively evaluated in our study. Findings: Changes in SBP, DBP and HR were compared in unmedicated, adrenaline, ephedrine and granisetron treated patient groups. SBP, DBP and HR changes were parallel. No statistically significant difference was found between the groups. According to the analysis of statistical data; SBP, DBP and HR decreased in all time periods after spinal anesthesia compared to baseline. It was observed that changes in SBP in the unmedicated group were close to the baseline measurements compared to the other groups. In ephedrine-treated patients, it was observed that SBP decreased rapidly and significantly in the supine position and at the 3rd minute, and approached the admission value at the 20th minute. In the group administered adrenaline, the decrease in SDB was marked and remained below the entry values. In patients who were given granisetron, it was observed that SBP followed a parallel course with the patients who were not given any drug. There was no statistically significant difference between the groups in terms of 1st minute and 5th minute Apgar measurement.