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Hypotension following combined spinal‐epidural anaesthesia for Caesarean section
Author(s) -
Mendonca C.,
Griffiths J.,
Ateleanu B.,
Collis R. E.
Publication year - 2003
Publication title -
anaesthesia
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.839
H-Index - 117
eISSN - 1365-2044
pISSN - 0003-2409
DOI - 10.1046/j.1365-2044.2003.03090.x
Subject(s) - medicine , supine position , ephedrine , anesthesia , sitting , interquartile range , caesarean section , position (finance) , surgery , pregnancy , finance , pathology , biology , economics , genetics
Summary Eighty‐seven pregnant mothers undergoing elective Caesarean section were randomly allocated either to the full left lateral position ( n = 45) or to the supine position with 12° left lateral tilt ( n = 42) after a combined spinal–epidural (CSE) in the sitting position and an initial 2 min in the full right lateral position. Fewer mothers were hypotensive while in the study position [29 (64%) in lateral group vs. 38 (90%) in the tilted supine group; p = 0.03]. Mothers in the lateral group tended to become hypotensive after turning them back to the tilted supine position immediately before surgery; hence the number of mothers who were hypotensive from the insertion of the CSE until delivery were similar [36 (80%) vs. 38 (90%)]. Mothers in the lateral group needed a lower dose of ephedrine to treat their hypotension while in their study position {median (interquartile range [range]) 6 (0–12 [0–36]) mg vs. 12 (6–18 [0–36]) mg, respectively; p = 0.04} but ephedrine requirements were similar overall {12 (6–12 [0–36]) mg vs. 12 (6–18 [0–36]) mg}, respectively. The full left lateral position reduces the incidence of early hypotension compared with the tilted supine position with tilt, and makes it easier to treat.