Influence of a prolonged lateral position on induction of spinal anesthesia for cesarean delivery: a randomized controlled trial.
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 - email@example.com.
This article was published in the following journal.
Name: Minerva anestesiologica
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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)
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