Investigation and Evaluation of Blood Pressure after Spinal Anesthesia

Abstract

Spinal anesthesia is a gold-standard technique for lower abdominal and obstetric procedures, yet it is frequently complicated by hemodynamic instability, specifically hypotension and bradycardia. This prospective observational study, conducted between September and November 2025, aimed to evaluate the perioperative hemodynamic and respiratory effects of spinal anesthesia while identifying patient-related risk factors, such as body mass index (BMI), associated with these clinical changes. The research involved a cohort of 83 patients across four major healthcare centers in Libya, including Benghazi and Sabha. Data collection synthesized participant demographics, comorbidities, and the serial measurement of vital signs at preoperative, intraoperative, and postoperative intervals. The results revealed a study population that was predominantly female (96.6%), with nearly 97% of cases originating from obstetrics and gynecology departments. Obesity was found to be highly prevalent, affecting 65.85% of the sample, with an additional 28.05% classified as overweight. Clinical findings indicated a significant and gradual perioperative decline in systolic blood pressure (SBP), diastolic blood pressure (DBP), and heart rate (p < 0.05 for all), while oxygen saturation levels remained remarkably stable throughout all stages. Although hypotension occurred in 36.1% of all cases, it was notably more frequent among obese patients at a rate of 74%. However, logistic regression analysis showed that the association between BMI and hypotension was not statistically significant (p = 0.075). The most frequently observed side effects included tremor (61.4%), headache (47.0%), and nausea (22.9%). The study concludes that while spinal anesthesia produces predictable hemodynamic alterations, the higher incidence of hypotension in obese patients necessitates rigorous continuous monitoring and individualized management to enhance patient safety within high-BMI obstetric populations.