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Randomized Controlled Trial
. 2015 Jan 5:21:52-8.
doi: 10.12659/MSM.892224.

Maternal position and development of hypotension in patients undergoing cesarean section under combined spinal-epidural anesthesia of intrathecal hyperbaric ropivacaine

Xin Wang  1 , Jun-Mei Xu  1 , Fan Zhou  1 , Liang He  1 , Yu-Long Cui  1 , Zhi-Jian Li  1
Affiliations
Randomized Controlled Trial

Maternal position and development of hypotension in patients undergoing cesarean section under combined spinal-epidural anesthesia of intrathecal hyperbaric ropivacaine

Xin Wang et al. Med Sci Monit. .

Abstract

Background: Spinal anesthesia (SA) is usually associated with hypotension in pregnant women. We sought to assess the influence of various maternal positions on SA-induced hypotension

Material/methods: The study population comprised 99 women at full-term gestation scheduled for elective cesarean section. They were randomized into 3 equal groups: the LL group, in which the patient was placed in the full left-lateral position until the start of surgery with the Whitacre needle bevel oriented laterally; the LS group, in which the patient was placed in the full left-lateral position initially and then shifted to the left-tilt supine position with the needle bevel oriented laterally; and the CS group, in which the patient was initially placed in the full left-lateral position and then shifted to the left-tilt supine position with the needle oriented in the cephalad direction.

Results: The incidences of hypotension in the LL, LS, and CS groups were 9.7%, 54.8%, and 56.3%, respectively. Ephedrine requirements were lower in the LL group than in the LS group (P<0.01).

Conclusions: The maternal position during the induction of anesthesia played an important role in the development of hypotension during cesarean delivery.

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Figures

Figure 1
Figure 1
Changes in systolic blood pressure following intrathecal injection. No significant difference was noted between the 3 groups.
Figure 2
Figure 2
Maximum block height (assessed by loss of pinprick sensation). * compared with group LS, P<0.05.
See this image and copyright information in PMC

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