[Compression stockings as prevention of hypotension in Cesarean section during spinal anesthesia]

Abstract

Inflatable splints and wrapping of the legs have been shown to be effective against hypotension during spinal anaesthesia for Caesarean section. The aim of this study was to investigate if compression stockings could have a similar effect. Thirty healthy mothers scheduled for elective Caesarean section were randomised to have either compression stockings or no stockings on before spinal anaesthesia. The stockings had a pressure effect of 54 mmHg. The women were preloaded with 20 ml isotonic NaCl one hour preoperatively. Hypotension was defined as either a decrease in systolic blood pressure to 80% of preoperative values or systolic blood pressure under 100 mmHg. Blood pressure was measured every second minute, and ephedrine 5 mg was given in the presence of hypotension. Two patients were excluded in the control group. There were no differences in demographic data, extension of blockade, and spinal injection to delivery time. Nine patients in the group with stockings had either no fall in blood pressure or a fall in blood pressure corrected with only 5 mg ephedrine. In the control group the corresponding number was four patients (p < 0.12). Ephedrine dose between zero and 20 minutes and total ephedrine dose was significantly lower in the group with stockings than in the control group (p < 0.038). Five patients in the control group experienced nausea, no patients in the study group had nausea (p < 0.013). In conclusion, compression stockings stabilised the blood pressure during Caesarean section in spinal anaesthesia and led to a significant smaller need for ephedrine.