Factors Affecting the Occurrence of Hypotension from Spinal Anesthesia in Patients Undergoing Surgery at Sirindhorn Hospital, Khon Kaen Province

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Published: Apr 30, 2026
DOI: https://doi.org/10.14456/jbidi.2026.3
Keywords:
Hypotension Spinal anesthesia Risk factors

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Narongsak Udomwong
Anesthesia Nursing Division, Sirindhorn Hospital, Khon Kaen Province

Abstract

           Hypotension is the most common physiological complication following spinal anesthesia. If not promptly monitored and managed, it may lead to inadequate perfusion of vital organs and potentially result in mortality. This study employed a retrospective cohort design to investigate the incidence and factors affecting the occurrence of hypotension from spinal anesthesia in patients undergoing surgery at Sirindhorn Hospital, Khon Kaen Province. Data were collected from medical records of patients who received spinal anesthesia between January 1, 2024 and December 31, 2024. A total of 211 participants were included, with the sample size determined using Cochran’s formula. Data were analyzed using descriptive statistics and multivariate logistic regression with   a forward stepwise method.
           The results indicated that 116 patients (54.98%) developed hypotension. In this study, hypotension was defined based on commonly accepted clinical criteria as a systolic blood pressure (SBP) of less than 90 mmHg or a decrease of more than 20% from baseline within 1 to 5 minutes after administration of spinal anesthesia. Multivariate logistic regression analysis identified several statistically significant factors in the final model, including female sex (Adjusted OR = 2.368, 95% CI: 1.254–4.472, p = 0.008), higher physiological status severity (ASA class ≥ 3) (Adjusted OR = 0.247 for ASA class 1–2 compared with class 3, 95% CI: 0.103–0.592, p = 0.002), higher level of anesthetic block (T11–T4) (Adjusted OR = 2.185, 95% CI: 1.366–3.494, p = 0.001), and baseline systolic blood pressure below 140 mmHg (Adjusted OR = 4.278, 95% CI: 2.188–8.366, p < 0.001).
          In conclusion, four key predictive factors were identified: female sex, ASA class ≥ 3, high-level spinal block (T11–T4), and lower baseline SBP. These findings suggest that nurse anesthetists should incorporate these factors into pre-anesthetic assessment and preparation protocols for patients undergoing spinal anesthesia. Appropriate preoperative fluid management and early preparation of vasopressors may help effectively prevent hypotension in high-risk patients.

Article Details

How to Cite
Udomwong, N. (2026). Factors Affecting the Occurrence of Hypotension from Spinal Anesthesia in Patients Undergoing Surgery at Sirindhorn Hospital, Khon Kaen Province. Journal of Bamrasnaradura Infectious Diseases Institute, 20(1), 24–32. https://doi.org/10.14456/jbidi.2026.3
Issue
Vol. 20 No. 1 (2026): Journal of Bamrasnaradura Infectious Diseases Institute Vol. 20 No. 1 January - April 2026
Section
Original Articles

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