Influence of a prolonged lateral position on induction of spinal anesthesia for cesarean delivery: a randomized controlled trial.

06:00 EDT 14th March 2012 | BioPortfolio

Summary of "Influence of a prolonged lateral position on induction of spinal anesthesia for cesarean delivery: a randomized controlled trial."

Maternal hypotension occurs commonly during cesarean delivery under spinal anesthesia. We evaluated whether hypotension due to aortocaval compression could be prevented by maintaining a lateral position after an intrathecal injection.
Eighty-six women undergoing elective cesarean delivery were enrolled. Spinal anesthesia was conducted in the right lateral position using 8 mg of hyperbaric bupivacaine and 15 µg of fentanyl. Patients were randomly assigned to maintain the right lateral position for 6 min before assuming the wedged supine position (group L), or to assume the wedged supine position immediately after the spinal injection (group S). Hypotension was defined as a decrease in mean arterial pressure to <80% of baseline. Ephedrine was given if blood pressure decreased to <70% of baseline. The incidence of hypotension and nausea, ephedrine requirement, maximal block height, and neonatal outcomes were evaluated.
No significant between-group differences were observed in the lowest blood pressure, total ephedrine dose, or incidence of hypotension or nausea. Onset of hypotension was delayed (6±2 vs. 10±3 min, P<0.001), and the sensory block level was more cephalad in group L than in group S (T2 [C8-T5] vs. T4 [T1-T6], P=0.001). Apgar scores did not differ between the groups.
During spinal anesthesia for elective cesarean delivery, maintaining the lateral position for 6 min after an intrathecal injection of hyperbaric bupivacaine resulted in a more gradual and higher cephalad sensory block, without an increase in the incidence of maternal hypotension.


Department of Anesthesiology and Pain Medicine, Seoul National University Bundang Hospital, Seongnam, South Korea -

Journal Details

This article was published in the following journal.

Name: Minerva anestesiologica
ISSN: 1827-1596


PubMed Articles [18734 Associated PubMed Articles listed on BioPortfolio]

Uterine Dehiscence During Initiation of Spinal Anesthesia for Cesarean Delivery.

Uterine dehiscence is a known but uncommon complication during pregnancy. The symptoms of uterine dehiscence can be subclinical and usually occur during prolonged augmented labor in women who had prev...

Teaching Neuraxial Anesthesia Techniques for Obstetric Care in a Ghanaian Referral Hospital: Achievements and Obstacles.

Anesthesia providers in low-income countries may infrequently provide regional anesthesia techniques for obstetrics due to insufficient training and supplies, limited manpower, and a lack of perceived...

Hyperbaric versus plain bupivacaine for spinal anesthesia for cesarean delivery.

Bupivacaine is an amide local anesthetic used in hyperbaric and plain forms administered as spinal anesthesia for cesarean delivery. In this systematic review, we summarized the effectiveness and safe...

Comparison of maternal and fetal outcomes among patients undergoing cesarean section under general and spinal anesthesia: a randomized clinical trial.

As the rates of cesarean births have increased, the type of cesarean anesthesia has gained importance. Here, we aimed to compare the effects of general and spinal anesthesia on maternal and fetal outc...

Spinal hemianesthesia: Unilateral and posterior.

The injection of a non-isobaric local anesthetic should induce a unilateral spinal anesthesia in patients in a lateral decubitus position. The posterior spinal hemianesthesia only be obtained with hyp...

Clinical Trials [4346 Associated Clinical Trials listed on BioPortfolio]

Effect of Position During Spinal Anesthesia on Hemodynamic Change in Cesarean Section

Hypotension is the most common complications after spinal anesthesia especially in pregnant patients who undergoing cesarean section. Position during spinal anesthesia may be altering the ...

Delayed Positioning in Cesarean Section

Maternal hypotension is a common problem during cesarian section under spinal anesthesia. The possible explanation for this is combined aortocaval compression by gravid uterus in parturien...

Influence of Anesthetic Temperature on Cephalad Sensory Blockade With Spinal Anesthesia

Several factors influence the extension of anesthetic mixture during spinal anesthesia including anesthetic gravity, body position, drug volume, and drug-delivering velocity. However, the ...

Fluid Management for Cesarean Section III

Regional anesthesia, including epidural, spinal and combined epidural spinal anesthesia (CSEA), is a pivotal part in modern anesthesiology. Previously, the investigators found that epidura...

Ephedrine vs. Nor Epinephrine Infusion in Preventing Hypotension After Spinal Anesthesia for Cesarean Section

The purpose of the study is to determine if norepinephrine is more effective as a continuous intravenous (IV) infusion compared to continuous IV ephedrine associated with crystalloid loadi...

Medical and Biotech [MESH] Definitions

An intravenous anesthetic that has been used for rapid induction of anesthesia and for maintenance of anesthesia of short duration. (From Martindale, The Extra Pharmacopoeia, 30th ed, p918)

A barbiturate that is administered intravenously for the production of complete anesthesia of short duration, for the induction of general anesthesia, or for inducing a hypnotic state. (From Martindale, The Extra Pharmacopoeia, 30th ed, p919)

Reduced blood flow to the spinal cord which is supplied by the anterior spinal artery and the paired posterior spinal arteries. This condition may be associated with ARTERIOSCLEROSIS, trauma, emboli, diseases of the aorta, and other disorders. Prolonged ischemia may lead to INFARCTION of spinal cord tissue.

Delivery of an infant through the vagina in a female who has had a prior cesarean section.

Extraction of the fetus by abdominal hysterotomy anytime following a previous cesarean.


Relevant Topics

Latest News Clinical Trials Research Drugs Reports Corporate
An anesthesiologist (US English) or anaesthetist (British English) is a physician trained in anesthesia and perioperative medicine. Anesthesiologists are physicians who provide medical care to patients in a wide variety of (usually acute) situations. ...

Latest News Clinical Trials Research Drugs Reports Corporate
Anesthesia is the loss of feeling or sensation in all or part of the body. It may result from damage to nerves or can be induced by an anesthetist (a medical professional) using anesthetics such as thiopental or propofol or sevoflurane during a surgical ...

Women's Health
Latest News Clinical Trials Research Drugs Reports Corporate
Women's Health - key topics include breast cancer, pregnancy, menopause, stroke Follow and track Women's Health News on BioPortfolio: Women's Health News RSS Women'...

Searches Linking to this Article