{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2025,7,30]],"date-time":"2025-07-30T09:54:02Z","timestamp":1753869242394,"version":"3.41.2"},"reference-count":29,"publisher":"Wiley","issue":"10","license":[{"start":{"date-parts":[[2024,10,16]],"date-time":"2024-10-16T00:00:00Z","timestamp":1729036800000},"content-version":"vor","delay-in-days":15,"URL":"http:\/\/creativecommons.org\/licenses\/by-nc\/4.0\/"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Health Science Reports"],"published-print":{"date-parts":[[2024,10]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:sec><jats:title>Background and Aims<\/jats:title><jats:p>Although Spinal Anesthesia (SA) remains the technique of choice for many surgeries below the umbilicus, it is associated with multiple intraoperative complications. Sympathetic blockade and Bezold\u2010Jarisch reflex do not fully explain SA\u2010related cardiopulmonary complications. Reduction in FEV<jats:sub>1<\/jats:sub> has been reported as a predictor of sudden cardiac death. This study aimed to determine the association between reduction in FEV<jats:sub>1<\/jats:sub> following SA and adverse intraoperative cardiopulmonary complications.<\/jats:p><\/jats:sec><jats:sec><jats:title>Materials and Methods<\/jats:title><jats:p>A prospective study of 48 patients of ASA status I and II with no history of primary cardiopulmonary disease scheduled for elective surgery under SA. Spirometry was performed based on ATS\/ERS guidelines before induction and 30\u2009min after induction of SA. FEV<jats:sub>1<\/jats:sub>% predicted was determined using GLI 2012 equations. Participants were grouped into two (\u2206FEV<jats:sub>1<\/jats:sub>%\u2009&lt;\u200910% and \u2206FEV<jats:sub>1<\/jats:sub>%\u2009\u2265\u200910%) based on reductions (\u2206) in FEV<jats:sub>1<\/jats:sub>% predicted following SA. Logistic regression analyses were used to examine associations between \u2206FEV<jats:sub>1<\/jats:sub>% and intraoperative hypoxia, hypotension, bradycardia, and nausea\/vomiting, with adjustments for age, gender, and BMI.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>The mean FEV<jats:sub>1<\/jats:sub>% predicted following SA was lower than the mean FEV<jats:sub>1<\/jats:sub>% predicted before SA (83.42 vs. 95.31, <jats:italic>p<\/jats:italic>\u2009=\u20090.001). In a fully adjusted model, \u2206FEV<jats:sub>1<\/jats:sub>%\u2009\u2265\u200910% was associated with an increased risk of hypoxia [AOR 13.55; 95% CI, 1.07\u2013171.24, <jats:italic>p<\/jats:italic>\u2009=\u20090.044]. The positive associations between \u2206FEV<jats:sub>1<\/jats:sub>%\u2009\u2265\u200910% and hypotension [2.02 (0.33\u201312.46), 0.449], bradycardia [1.10 (0.28\u20134.25), 0.895] and nausea\/vomiting [9.74 (0.52\u2013183.94), 0.129] were not statistically significant.<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusion<\/jats:title><jats:p>Reduction in FEV<jats:sub>1<\/jats:sub>% predicted following SA was associated with adverse intraoperative outcomes. FEV<jats:sub>1<\/jats:sub> may play an important role in the association between SA and cardiopulmonary complications.<\/jats:p><\/jats:sec>","DOI":"10.1002\/hsr2.70073","type":"journal-article","created":{"date-parts":[[2024,10,17]],"date-time":"2024-10-17T05:19:04Z","timestamp":1729142344000},"update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["Reduction in FEV<sub>1<\/sub> following spinal anesthesia is associated with intraoperative complications: A prospective study"],"prefix":"10.1002","volume":"7","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-8230-888X","authenticated-orcid":false,"given":"Melody Kwatemah","family":"Agyei\u2010Fedieley","sequence":"first","affiliation":[{"name":"Department of Anaesthesia Greater Accra Regional Hospital  Accra Ghana"},{"name":"Department of Physiology University of Ghana Medical School  Accra Ghana"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Ebenezer Owusu","family":"Darkwa","sequence":"additional","affiliation":[{"name":"Department of Physiology University of Ghana Medical School  Accra Ghana"},{"name":"Department of Anaesthesia Korle Bu Teaching Hospital  Accra Ghana"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Charles F.","family":"Hayfron\u2010Benjamin","sequence":"additional","affiliation":[{"name":"Department of Physiology University of Ghana Medical School  Accra Ghana"},{"name":"Department of Anaesthesia Korle Bu Teaching Hospital  Accra Ghana"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Adeyemi","family":"Olufolabi","sequence":"additional","affiliation":[{"name":"Department of Anesthesia Duke University Hospital Durham North Carolina USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Evans","family":"Atito\u2010Narh","sequence":"additional","affiliation":[{"name":"Department of Anaesthesia Greater Accra Regional Hospital  Accra Ghana"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Jerry","family":"Agudogo","sequence":"additional","affiliation":[{"name":"Department of Anaesthesia Greater Accra Regional Hospital  Accra Ghana"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-2325-7063","authenticated-orcid":false,"given":"Bartholomew","family":"Dzudzor","sequence":"additional","affiliation":[{"name":"Department of Medical Biochemistry University of Ghana Medical School  Accra Ghana"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"311","published-online":{"date-parts":[[2024,10,16]]},"reference":[{"issue":"2","key":"e_1_2_10_2_1","first-page":"167","article-title":"Spinal anaesthesia\u2014an update","volume":"113","author":"Gligorijevic S","year":"2011","journal-title":"Period Biol"},{"key":"e_1_2_10_3_1","doi-asserted-by":"publisher","DOI":"10.4314\/ahs.v15i2.21"},{"key":"e_1_2_10_4_1","doi-asserted-by":"publisher","DOI":"10.1111\/anae.13702"},{"volume-title":"Spinal Anesthesia [Internet]","year":"2020","author":"Olawin AMMDJ","key":"e_1_2_10_5_1"},{"key":"e_1_2_10_6_1","doi-asserted-by":"publisher","DOI":"10.1177\/2192568218795867"},{"key":"e_1_2_10_7_1","doi-asserted-by":"publisher","DOI":"10.1016\/S0034-7094(11)70012-5"},{"issue":"09","key":"e_1_2_10_8_1","first-page":"7","article-title":"Comparison between the side effects of spinal and general anesthesia during caesarean section in Tripoli Libya","volume":"06","author":"Amjad T","year":"2015","journal-title":"J Anesth Clin Res"},{"key":"e_1_2_10_9_1","doi-asserted-by":"publisher","DOI":"10.1097\/00000542-200305000-00030"},{"issue":"2","key":"e_1_2_10_10_1","first-page":"113","article-title":"Effects of ondansetron on attenuating spinal anesthesia\u2010induced hypotension and bradycardia in obstetric and nonobstetric subjects: a systematic review and meta\u2010analysis","volume":"85","author":"Kane TD","year":"2017","journal-title":"AANA J"},{"key":"e_1_2_10_11_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.ijcard.2017.02.012"},{"key":"e_1_2_10_12_1","doi-asserted-by":"publisher","DOI":"10.3109\/07853890.2015.1036111"},{"key":"e_1_2_10_13_1","doi-asserted-by":"publisher","DOI":"10.1111\/j.1365-2044.1996.tb15046.x"},{"issue":"5","key":"e_1_2_10_14_1","first-page":"1417","article-title":"Pulmonary effects of bupivacaine and ropivacaine in parturients undergoing spinal anesthesia for elective cesarean delivery","volume":"7","author":"Geng G","year":"2014","journal-title":"Int J Clin Exp Med"},{"key":"e_1_2_10_15_1","doi-asserted-by":"publisher","DOI":"10.1177\/201010581402300110"},{"key":"e_1_2_10_16_1","doi-asserted-by":"publisher","DOI":"10.1183\/09031936.00080312"},{"issue":"3","key":"e_1_2_10_17_1","first-page":"9398","article-title":"TY. which finger do you attach pulse oximetry to? 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