Leg elevation decreases the incidence of post-spinal hypotension in cesarean section: a randomized controlled trial

BMC Anesthesiology

Research Article

Ahmed Hasanin¹  Ahmed Aiyad¹  Mohamed Osman¹  Atef Kamel¹  Sherin Refaat¹  Ahmed Elsakka¹  Ali Mokhtar¹  Yasmin Hassabelnaby¹  Reham Fouad² 

[1] Department of Anesthesia and Critical Care Medicine, Cairo University, Cairo, Egypt;Department of Obstetrics and Gynecology, Cairo University, Cairo, Egypt;

关键词: Hypotension;    Spinal anesthesia;    Cesarean section;    Leg elevation;   

DOI  :  10.1186/s12871-017-0349-8

 received in 2016-09-22, accepted in 2017-04-10,  发布年份 2017

来源: Springer

【 摘 要 】

BackgroundMaternal hypotension is a common complication after spinal anesthesia for cesarean section (CS). In this study we investigated the role of leg elevation (LE) as a method for prevention of post-spinal hypotension (PSH) for cesarean section.MethodsOne hundred and fifty full term parturients scheduled for CS were included in the study. Patients were randomized into two groups: Group LE (leg elevation group, n = 75) and group C (Control group, n = 75). Spinal block was performed in sitting position after administration of 10 mL/Kg Ringer’s lactate as fluid preload. After successful intrathecal injection of local anesthetic, Patients were positioned in the supine position. Leg elevation was performed for LE group directly after spinal anesthesia and maintained till skin incision. Intraoperative hemodynamic parameters (Arterial blood pressure and heart rate), intra-operative ephedrine consumption, incidence of PSH, and incidence of nausea and vomiting were reported.ResultsLE group showed lower incidence of PSH (34.7% Vs 58.7%, P = 0.005) compared to the control group. Arterial blood pressure was higher in the LE group compared to the control group in the first two readings after spinal block. Other readings showed comparable arterial blood pressure and heart rate values between both study groups; however, LE showed less ephedrine consumption (4.9 ± 7.8 mg Vs 10 ± 11 mg, P = 0.001).ConclusionLE performed immediately after spinal block reduced the incidence of PSH in parturients undergoing CS.Trial registrationThe study was registered at Pan African Clinical Trials Registry system on 5/10/2015 with trial number PACTR201510001295348.

【 授权许可】

CC BY   
© The Author(s). 2017