Institute for Medical Research, National Institute of Republic of Serbia, University of Belgrade , Belgrade , Serbia
Faculty of Medicine, University of Novi Sad , Novi Sad , Serbia
Clinic for Anesthesia, Intensive Care and Pain Medicine, University Clinical Centre of Vojvodina
Clinic for Gastroenterology and Hepatology, University Clinical Centre of Vojvodina , Novi Sad , Serbia
Spinal anesthesia is widely regarded as the “gold standard” for elective cesarean sections due to its rapid onset and reduced risk of complications associated with general anesthesia. However, hypotension remains a frequent adverse effect, influenced by maternal and procedural factors. Despite preventive measures, predicting hypotension based on patient characteristics remains challenging. This study investigates the relationship between hypotension and variables including age, BMI, height, preoperative fasting, and hypertension during pregnancy. A retrospective analysis was conducted on 123 patients undergoing elective cesarean section under spinal anesthesia from April to August 2023 at the Clinic of Gynecology and Obstetrics, Novi Sad. Demographic data, anesthetic dose, timing of surgery, and blood pressure trends were collected. Patients were categorized by delivery time, height, hypotension occurrence, and hypertension history. Statistical analysis included t-test, Mann–Whitney U, chi-square, ANOVA, and correlation testing. Hypotension occurred in 45.5% of patients. Older age was significantly associated with hypotension (p=0.031), whereas hypertension during pregnancy correlated with a lower incidence (p=0.032). Height, BMI, and surgery timing showed no significant impact on hypotension risk. Taller patients received higher anesthetic volumes (p=0.005), with a moderate correlation between height and dose (rho=0.427, p<0.001), but anesthetic dose did not predict hypotension. Most hypotensive events occurred within 10 minutes post-anesthesia. Hypotension was associated with older age, while hypertension during pregnancy appeared protective. No associations were found with height, BMI, or fasting duration. Findings highlight the need for individualized monitoring and larger-scale studies to optimize spinal anesthesia management in cesarean delivery.
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