Incidence and predictors of post spinal anesthesia-induced hypotension for cesarean section in Ethiopia: A systematic review and meta-analysis

IF 1 Q2 Nursing

Perioperative Care and Operating Room Management Pub Date : 2025-08-13 DOI:10.1016/j.pcorm.2025.100541

Sintayehu Samuel Lorato , Feleke Doyore Agide , Genanew Kassie Getahun , Kedir Seid Yesuf , Yohannes Addisu Wondimagne , Mitiku Desalegn , Dawit Tesfaye Rundasa , Yohannes Godie , Tolasa Yadate , Yisehak wolde , Eyob Ketema Bogale

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引用次数: 0

Abstract

Introduction

Hypotension is defined as a decrease in mean arterial blood pressure of more than 30% within a 10-minute period after spinal anesthesia. Spinal anesthesia is a subarachnoid block and is the preferred approach for certain surgical procedures, such as cesarean sections. Spinal anesthesia is the most often used neuraxial approach for patients in many institutions because of the superior quality of surgical anesthesia, quick onset of action, excellent patient comfort, and low complication rates. This systematic review and meta-analysis aimed to assess the incidence of SIH and related factors among patients who underwent cesarean sections in Ethiopia.

Methods

This systematic review and meta-analysis was conducted using two different methods. The first was an exploration of electronic databases (PubMed, Scopus, Web of Science, MEDLINE, CINAHL, Cochrane Library, Embase, and Google Scholar) for the presence of evidence about the incidence of spinal-induced hypotension and its predictors among pregnant mothers who underwent cesarean section under spinal anesthesia in Ethiopia. Data were extracted using a Microsoft Excel spreadsheet and analyzed using Stata 17. Quality appraisal was conducted using the PRISMA guidelines and Newcastle‒Ottawa assessment scales. Higgins I2 tests were used to assess heterogeneity. Sensitivity and subgroup analyses were performed. Egger's test and funnel plots were employed to identify potential publication bias.

Results

The pooled incidence of SIH among pregnant women who underwent cesarean section in Ethiopia was 64.5% (95% CI: 56.2–72.8). The subgroup analysis by region revealed that the pooled incidence of SIH among pregnant mothers in Addis Ababa was 68.6%, and that in the Oromia region was 74%. Baseline systolic blood pressure <120 mmHg (AOR 6, 95% CI 2.878–9.09), newborn weight (AOR 5.4, 95% CI 3.4–7.35), sensory block height (AOR 6.75, 95% CI 4.3–9.201), speed of injection < 10 sec (AOR 4.47, 95% CI 2.348–6.215), and dose of local anesthetics > 2.5 ml (AOR 7.8, 95% CI 6.3–11.56) were significantly associated with SIH.

Conclusion

This systematic review and meta-analysis revealed a high pooled incidence of SIH among pregnant women who underwent cesarean section under spinal anesthesia in Ethiopia. Hence, to reduce SIH and other maternal-related complications among pregnant women, much consideration must be given to increasing anesthesia professionals’ knowledge and skills in teaching universities and governmental hospitals in Ethiopia.

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埃塞俄比亚剖宫产术后脊髓麻醉所致低血压的发生率和预测因素：系统回顾和荟萃分析

低血压的定义是脊髓麻醉后10分钟内平均动脉血压下降超过30%。脊髓麻醉是一种蛛网膜下腔阻滞，是某些外科手术（如剖宫产）的首选方法。脊髓麻醉是许多机构中最常用的神经轴入路，因为手术麻醉质量好，起效快，患者舒适度好，并发症发生率低。本系统综述和荟萃分析旨在评估埃塞俄比亚剖宫产患者中SIH的发生率及相关因素。方法采用两种不同的方法进行系统评价和荟萃分析。首先是对电子数据库（PubMed、Scopus、Web of Science、MEDLINE、CINAHL、Cochrane Library、Embase和谷歌Scholar）的探索，寻找埃塞俄比亚脊柱麻醉下剖宫产孕妇脊柱性低血压发生率及其预测因素的证据。使用Microsoft Excel电子表格提取数据，并使用Stata 17进行分析。使用PRISMA指南和纽卡斯尔-渥太华评估量表进行质量评估。采用Higgins I2检验评估异质性。进行敏感性和亚组分析。采用Egger检验和漏斗图来确定潜在的发表偏倚。结果埃塞俄比亚剖宫产孕妇SIH的总发生率为64.5% （95% CI: 56.2-72.8）。按地区进行亚组分析，亚的斯亚贝巴孕妇SIH总发病率为68.6%，奥罗米亚地区为74%。基线收缩压120 mmHg （AOR 6, 95% CI 2.878-9.09）、新生儿体重（AOR 5.4, 95% CI 3.4-7.35）、感觉阻滞高度（AOR 6.75, 95% CI 4.3-9.201）、注射速度（AOR 4.47, 95% CI 2.348-6.215）、局麻药剂量（AOR 7.8, 95% CI 6.3-11.56）与SIH显著相关。结论：本系统综述和荟萃分析显示，埃塞俄比亚脊柱麻醉下剖宫产的孕妇SIH发生率较高。因此，为了减少孕妇的SIH和其他与产妇有关的并发症，必须在埃塞俄比亚的教学大学和政府医院中充分考虑提高麻醉专业人员的知识和技能。

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来源期刊

Perioperative Care and Operating Room Management Nursing-Medical and Surgical Nursing

CiteScore

1.30

自引率

0.00%

发文量

审稿时长

56 days

期刊介绍： The objective of this new online journal is to serve as a multidisciplinary, peer-reviewed source of information related to the administrative, economic, operational, safety, and quality aspects of the ambulatory and in-patient operating room and interventional procedural processes. The journal will provide high-quality information and research findings on operational and system-based approaches to ensure safe, coordinated, and high-value periprocedural care. With the current focus on value in health care it is essential that there is a venue for researchers to publish articles on quality improvement process initiatives, process flow modeling, information management, efficient design, cost improvement, use of novel technologies, and management.