Effect of Position during Induction of Spinal Anaesthesia for Caesarean Section on Maternal Haemodynamic: Randomised Clinical Trial
Dr. Pourfathi Hojjat,
Assistant Professor, Department of Anaesthesiology, Tabriz University of Medical Sciences, Iran.
Introduction: Hypotension is common after spinal anaesthesia during caesarean section (c/s). Methods for prevention of hypotension are mechanical approaches such as leg rise, compression stocks and positioning. On the other hand, mother position may have an effect on haemodynamic variables due to speed of onset of sensory block. Position during induction has maternal and foetal importance.
Aim: To compare the maternal haemodynamic variables after spinal anaesthesia in sitting or lateral decubitus position in patients undergoing c/s.
Materials and Methods: In this prospective, randomised and double-blinded clinical trial, 76 healthy parturient, undergoing c/s, were allocated in two groups. The study was conducted from September 2014 to August 2015 at Al-Zahra Hospital. Spinal anaesthesia was induced in lateral decubitus position (study group; n=38) or sitting position (control group; n=38). Maternal haemodynamic, block characteristic, side effects, and neonate Apgar scores were recorded. Data were analysed using SPSS version 16.0 software and students t-test, Chi-square test, and Mann Whitney U test were used for statistical analysis.
Results: Incidence of hypotension (50% vs 76.3%; p=0.016), bradycardia (0% vs 21.1%; p=0.014) and vasopressors consumption (36.2% vs 76.3%; p=0.012) were statistically lower in lateral position. There was no significant differences in sensory height (p=0.89) and duration of sensory and motor block between two groups (p=0.42, p=0.29; respectively).
Conclusion: The changes in maternal haemodynamic were significantly lower in lateral position than sitting position in patients undergoing spinal anaesthesia for c/s.