Prevention of post-spinal hypotension at elective cesarean section by wrapping of the lower limbs

Abstract

Objective: To investigate whether wrapping and/or elevation of the legs prevents post-spinal hypotension at cesarean section (CS).

Methods: 82 parturients in a community hospital were randomly allocated to one of 4 groups: raising, wrapping, raising and wrapping of the legs and no intervention. The outcome measures were the upper level of blockade, pulse rate and arterial systolic pressure (SAP). Statistical evaluation included paired and unpaired t-test, contingency table analysis and repeated measures analysis of variance.

Results: The SAP remained significantly higher with wrapping; elevation did not add any benefit. The number of episodes of severe hypotension (defined as a SAP decrease > or = 20% of baseline and < 100 mmHg) was significantly reduced by wrapping (15.8% of cases) as compared to controls (45.5%)(chi2 = 11.02; P = 0.012). Elevation alone did not prevent hypotension (chi2 = 0.76; P = 0.38).

Conclusion: Wrapping of the legs at spinal block for Cs is recommended to reduce hypotension.