THE RELATIONSHIP OF BLOOD PRESSURE CHANGES TO THE INCIDENCE OF IONV IN HYPERTENSIVE PATIENTS WHO UNDERWENT REGIONAL ANESTHESIA
DOI:
https://doi.org/10.61677/jth.v4i2.943Keywords:
Regional anesthesia, spinal anesthesia, IONV, intraoperative blood pressure changes, intraoperative hypotensionAbstract
Spinal anesthesia produces sympathetic blockade, which can cause vasodilation and intraoperative hypotension (IOH), one of the most common hemodynamic complications. Intraoperative hypotension may be defined using absolute thresholds, such as mean arterial pressure (MAP) <65–70 mmHg, or relative thresholds, such as a decrease of >20% from baseline. Hemodynamic changes during spinal anesthesia may contribute to intraoperative nausea and vomiting (IONV). This study aimed to determine the relationship between intraoperative blood pressure changes and the incidence of intraoperative nausea and vomiting (IONV) in hypertensive patients undergoing spinal anesthesia. This study used an analytical observational design with a cross-sectional approach. A total of 59 hypertensive patients undergoing surgery under spinal anesthesia were recruited using consecutive sampling. The independent variable was intraoperative blood pressure change, while the dependent variable was IONV. The relationship between the variables was analyzed using Spearman’s rho correlation test. There was a statistically significant correlation between intraoperative blood pressure changes and IONV (Spearman’s ρ = −0.538, p < 0.001). A statistically significant correlation was found between intraoperative blood pressure changes and IONV among hypertensive patients undergoing spinal anesthesia. These findings highlight the importance of careful intraoperative hemodynamic monitoring in this population.
References
Adiputra, I. M. S., Trisnadewi, N. W., Oktaviani, N. P. W., Munthe, S. A., Hulu, V. T., Budiastutik, I., Faridi, A., Ramdany, R., Fitriani, R. J., Tania, P. O. A., Rahmiati, B. F., Lusiana, S. A., Susilawaty, A., Sianturi, E., & Suryana. (2021). Metodologi penelitian kesehatan. Yayasan Kita Menulis.
Arsani, F., Cipta, C. R., & Purwaningsih, H. (2022). Hubungan hipotensi dengan kejadian post operative nausea and vomiting (PONV) pada pasien pasca spinal anestesi. Jurnal Ilmiah Kedokteran dan Kesehatan, 1(3), 179–188. https://doi.org/10.55606/klinik.v1i3.2182
Demilew, B. C., Zurbachew, N., Getachew, N., Mekete, G., & Teshome, D. (2025). Prevalence and associated factors of intraoperative nausea and vomiting of mothers who gave birth with cesarean section under regional anesthesia: A systematic review and meta-analysis; 2023. BMC Pregnancy and Childbirth, 25(1), 1-15. https://doi.org/10.1186/s12884-025-07363-z
Goss, S., Jedlicka, J., Strinitz, E., Niedermayer, S., Chappell, D., Hofmann-Kiefer, K., Hinske, L. C., & Groene, P. (2024). Association between intraoperative hypotension and postoperative nausea and vomiting: A retrospective cohort study. Current Medical Research and Opinion, 40(8), 1439–1448. https://doi.org/10.1080/03007995.2024.2373885
Halim, N. A., Masdar, A., Sayed Masri, S. N. N., Khalid, I., Budiman, M., & Cheah, S. (2026). The effect of using Hypotension Prediction Index to reduce intraoperative hypotension in elective cesarean sections: A randomized controlled trial. Medicina, 62(8), 1-16. https://doi.org/10.3390/medicina62081486
Kouz, K., Hoppe, P., Briesenick, L., & Saugel, B. (2020). Intraoperative hypotension: Pathophysiology, clinical relevance, and therapeutic approaches. Indian Journal of Anaesthesia, 64(2), 90–96. https://doi.org/10.4103/ija.IJA_939_19
Liu, Y.-C., Zhong, H.-H., Dai, Z., Huang, Y., Liu, Y.-B., He, H., Liao, Y.-Q., & Liu, W. (2025). Predicting postoperative nausea and vomiting after cesarean section: A nomogram model combined with gastric ultrasound. BMC Anesthesiology, 25(64), 1-11. https://doi.org/10.1186/s12871-025-02936-z
Nakatani, H., Naito, Y., Ida, M., Sato, M., Okamoto, N., Nishiwada, T., & Kawaguchi, M. (2023). Association between intraoperative hypotension and postoperative nausea and vomiting: A retrospective analysis of 247 thyroidectomy cases. Brazilian Journal of Anesthesiology, 73(5), 635–640. https://doi.org/10.1016/j.bjane.2021.02.029
Puri, R., Situ, S., Minhas, H. S., Rastogi, B., Solanki, A., & Niharika. (2023). Is low dose ketamine effective as antiemetic prophylaxis for intraoperative nausea and vomiting during caesarean section under spinal anaesthesia: A prospective randomized study. Global Journal for Research Analysis, 12(2), 4–7. https://doi.org/10.36106/gjra/0903313
Ruppen, I. C., Ricardo de Oliveira, R., Morsoletto, J. M. Q., Vasconcellos, V. R. B., Sordi, M., Watanabe, K. K., Moraes da Costa Júnior, L. F., Durante, V. R. F., Gurgel, R. V. T., Biscaia, J. V. F., Zanini, C. A., Consalter de Mello, M. R., Gaeski de Chaves, J. R., & Bitiati, L. B. D. (2025). Plastic surgery and anesthesia management, risks and complication control: A brief review. Journal of Medical Research and Surgery, 6(3), 57–59. https://doi.org/10.52916/jmrs254171
Shams, D., Sachse, K., Statzer, N., & Gupta, R. K. (2024). Regional anesthesia complications and contraindications. Anesthesiology Clinics, 42(2), 329–344. https://doi.org/10.1016/j.anclin.2023.11.013
Staheli, B., & Rondeau, B. (2023). Anesthetic considerations in the geriatric population. In StatPearls [Internet]. StatPearls Publishing.
Weinberg, L., Li, S. Y., Louis, M., Karp, J., Poci, N., Carp, B. S., Miles, L. F., Tully, P., Hahn, R., Karalapillai, D., & Lee, D.-K. (2022). Reported definitions of intraoperative hypotension in adults undergoing non-cardiac surgery under general anaesthesia: A review. BMC Anesthesiology, 22(69), 1-12. https://doi.org/10.1186/s12871-022-01605-9
Woodford, S. F., Rinehart, J. B., Peyton, P. J., & Riedel, B. (2025). Clarity in hemodynamics and end-organ perfusion: Pulsatility, patient phenotype, and the pressure field as a novel approach. Anesthesia & Analgesia, 141(1), 113–119. https://doi.org/10.1213/ANE.0000000000007465
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