ArticleJournal of anaesthesiology, clinical pharmacology
Dynamic pupillometry to predict hypotension after spinal anesthesia in patients with diabetes mellitus - A prospective observational study.
Article in Journal of anaesthesiology, clinical pharmacology. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.
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Abstract
Background and Aims: Hypotension is a common adverse effect of spinal anesthesia and poses increased risks for patients with diabetes mellitus. While various tests exist for diagnosing diabetic autonomic neuropathy, dynamic pupillometry is a simple and cost-effective option. This study aimed to assess whether dynamic pupillometry can predict post-spinal hypotension in diabetic patients. Material and Methods: In this observational study, 75 patients with diabetes mellitus who were scheduled for surgery under spinal anesthesia underwent a pupillary examination the day prior. Both static and dynamic parameters were recorded. On the day of surgery, 3 ml of 0.5% hyperbaric bupivacaine was administered for spinal anesthesia, and instances of intraoperative hypotension and the use of vasopressors were noted. Results: Post-spinal hypotension occurred in 77% of the 75 patients studied, with 27 experiencing mild hypotension (20-30% drop in MAP) and 31 having severe hypotension (>30% drop). The severe hypotension group had a significantly lower baseline pupil radius (3.86 ± 0.52 mm) compared to the no hypotension group (4.37 ± 0.57 mm, Conclusions: Baseline pupil radius measured using pupillometry may serve as a simple noninvasive marker to identify diabetic patients at risk of post-spinal hypotension.
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