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Leg elevation and wrapping in the prevention of hypotension following spinal anaesthesia for elective Caesarean section
Author(s) -
ROUT C. C.,
ROCKE D. A.,
GOUWS E.
Publication year - 1993
Publication title -
anaesthesia
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.839
H-Index - 117
eISSN - 1365-2044
pISSN - 0003-2409
DOI - 10.1111/j.1365-2044.1993.tb06948.x
Subject(s) - medicine , ephedrine , anesthesia , caesarean section , elective caesarean section , spinal anesthesia , bolus (digestion) , intravenous bolus , surgery , pregnancy , biology , genetics
Summary Ninety‐seven parturients undergoing elective Caesarean section were allocated randomly to have their legs elevated to approximately 30° on pillows or elevated and wrapped with elasticated Esmarch bandages or neither (controls) following spinal anaesthesia. All patients received intravenous crystalloid (20 ml.kg −1 over 20 min) prior to spinal injection and were placed in the left lateral tilt position. Significant hypotension was treated with intravenous ephedrine in 5 mg bolus doses. Leg wrapping resulted in a significant reduction in the incidence ofpostspinal hypotension in comparison to the control group (18% compared to 53%, p = 0.004). This represents a five‐fold reduction in the likelihood ofpostspinal hypotension (odds ratio 5.3, 95% CI 1.7–16.3). Leg elevation alone did not significantly reduce the incidence of hypotension (39%). There was no significant difference in the time of onset of hypotension between the groups. For those patients requiring ephedrine, there was no significant difference in mean dose requirements between the groups. The use of leg compression immediately postspinal provides a simple means of reducing the accompanying hypotension and should be used more widely.