Franken, D.E.J. (2018) Cerebrospinal fluid catecholamines: A predictor of spinal induced hypotension? thesis, Medicine.
Full text available on request.Abstract
Background: Hypotension is the most common noticed side effect during spinal anesthesia, which can be profound and quick in onset. Considerable variation in hypotension is observed, especially in the elderly, and is not completely understood. An active autonomous nervous system (ANS) with a high vasomotor tone might contribute to the variation in blood pressure changes. This study was designed to measure the ANS activity in the cerebrospinal fluid (CSF) with the analysis of catecholamines and to correlate this activity to hemodynamic alterations. Methods: The study design is cross-sectional with the data provided by the Anesthetic Biobank of Cerebrospinal fluid (ABC). Catecholamines from CSF of 101 patients were analyzed, sensory block height was determined and a peri-operative hemodynamic timeline was formed. The combined effect of the catecholamines and block height was tested by the multiple linear regression model to predict the change in blood pressure during spinal anesthesia. Results: The regression model showed that CSF norepinephrine concentration and block height are significantly correlated with the change in blood pressure (p < 0.001, p < 0.001) during spinal anesthesia. These two variables are responsible for 25.5 percent of the observed variability in the difference of blood pressure (R²). The significance was mostly due to the one extreme, which indicates a fragile study result. Conclusion: A weak but significant correlation between the CSF norepinephrine concentration and the changes in blood pressure was found. The prevention of hypotension is clinically relevant, although the clinical impact of this study is limited mostly due to technical difficulties. Additional research is needed to unravel the underlying mechanism of blood pressure maintenance.
| Item Type: | Thesis (Thesis) |
|---|---|
| Supervisor name: | Supervisor: and Absalom, Prof. dr. A.R. and Co-supervisor: and Atmosoerodjo, Drs. S.D.PhD candidate and Department: Anesthesiology, University Medical Centre Gronin |
| Faculty: | Medical Sciences |
| Date Deposited: | 25 Jun 2020 11:00 |
| Last Modified: | 25 Jun 2020 11:00 |
| URI: | https://umcg.studenttheses.ub.rug.nl/id/eprint/2028 |
Actions (login required)
 |
View Item |