(Anesth Analg. 2015;121:767–775)
Monitoring of both absolute values and clinically significant changes in patient blood pressure (BP) during cesarean delivery (CD) is important for patient welfare. A 20% increase or decrease in BP from baseline normally triggers treatment intervention. Common practice is to take the BP measurement from the upper arm. However, shivering or arm movement during delivery can lead to BP inaccuracies. Studies have shown leg measurements to be ineffective at detecting changes in BP in this patient population, and the forearm/wrist area has been suggested as an alternative as it has less muscle mass and is less prone to movement. In this single-center, prospective, observational study, authors compared upper arm measurements to wrist BP measurements in 49 nonobese pregnant women (older than 19 y) undergoing elective CD under spinal or combined spinal-epidural anesthesia. They hypothesized that change in wrist systolic BP (sBP) would trend with change measured at the same time in the upper arm, with an absolute difference between methods of <±10%.