Monitoring of hypotension after spinal anesthesia in cesarean section with continuous non-invasive arterial pressure measurement

We compared continuous non-invasive arterial pressure device and intermittent oscillometric arterial pressure measurement in maintaining hemodynamic stability during spinal anaesthesia for cesarean section. One hundred American Society of Anesthesiologists (ASA) I-II parturients undergoing elective cesarean section under spinal anesthesia were included. Based on a random number table, the parturients were assigned to receive either CNAP (group C) or NIAP (group N) monitoring. Following routine spinal anesthesia, phenylephrine 50 ug was intravenously administered once hypotension was detected and repeated administration was considered if there was no improvement 1 min after initial administration. The time of hypotension occurrence after spinal anesthesia, the lowest value of systolic blood pressure (SBP), neonatal Apgar score, and umbilical cord blood gas analysis were recorded in both groups. The incidence of hypotension after spinal anesthesia was similar in both groups (N: 35.6% vs C: 37.8%, P=1.0). However, severe hypotension was significantly less likely to occur in group C than in group N (11.1% vs 28.9%, P=0.035). Hypotension was detected significantly earlier in group C compared to group N (240 (58) s vs 349 (79) s, P=0.000). In parturients who developed hypotension, the maximum decrease in mean SBP was significantly smaller in group C than in group N (26.7% vs 31.9%, P=0.01). There were no significant differences in maternal adverse effects after spinal anesthesia, neonatal Apgar score, or blood gas analysis between both groups (P>0.05). We suggested the superiority of this technique in maintaining hemodynamic stability in parturients and consequently improving maternal and infant outcomes.