Using heart rate variability to stratify risk of obstetric patients undergoing spinal anesthesia

In this study, we evaluated whether point correlation dimension (PD2), a measure of heart rate variability, can predict hypotension accompanying spinal anesthesia for cesarean delivery. After the administration of spinal anesthesia with bupivacaine, hypotension was defined as systolic blood pressure less than or equal to 75% of baseline within 20 min of intrathecal injection. Using the median prespinal PD2 (3.90) to form 2 groups, LO and HI, all 11 hypotensive patients were in the LO group, and all 11 patients without hypotension were in the HI group. Baseline heart rate in the LO group was 95 bpm (10.2 So), versus 81 bpm (9.6 SD) in the HI group. PD2 shows promise as a predictor of hypotension in pregnant women receiving spinal anesthesia.