HEMODYNAMIC RESPONSE AND VASOPRESSOR REQUIREMENT DURING SPINAL ANESTHESIA IN HYPERTENSIVE VERSUS NORMOTENSIVE PATIENTS UNDERGOING LOWER LIMB SURGERY

Abstract

Spinal anesthesia is widely used for lower limb surgery because of its rapid onset, cost-effectiveness, and excellent postoperative analgesia. However, sympathetic blockade can lead to hemodynamic instability, particularly in patients with hypertension due to chronic cardiovascular adaptations such as vascular remodeling, impaired baroreceptor sensitivity, and altered autonomic regulation. To compare hemodynamic response and vasopressor requirement during spinal anesthesia in hypertensive versus normotensive patients undergoing lower limb surgery. A prospective observational comparative study was conducted at Heavy Industry Taxila (HIT) Hospital over a period of approximately four months. A total of 110 patients were enrolled using convenience sampling, including 55 controlled hypertensive patients (Group B) and 55 normotensive patients (Group A). inclusion was age 18-70 years, either gender, ASA class I, II, III. The incidence of bradycardia, hypotension, and vasopressor requirement was compared between the two groups. Hypertensive patients exhibited significantly higher rates of bradycardia (p = 0.004), hypotension (p = 0.007), and vasopressor requirement (p = 0.004) compared with normotensive patients undergoing lower limb surgery under spinal anesthesia. The study revealed that the All-observed differences were statistically significant (p < 0.05). Hypertensive patients undergoing lower limb surgery under spinal anesthesia experience significantly greater hemodynamic instability, characterized by higher rates of bradycardia, hypotension, and vasopressor requirement, compared with normotensive patients. Enhanced perioperative monitoring and timely management are therefore essential in this population