Open AccessEffect of Sequential Compression Device on Hemodynamic Changes After Spinal Anesthesia for Caesarean Section: A Randomized Controlled Trial
Author(s) -
Fatemeh Javaherforooshzadeh,
Mohammad Hassan Pipelzadeh,
Reza Akhondzadeh,
Sara Adarvishi,
Mostafa Alghozat
Publication year - 2020
Publication title -
anesthesiology and pain medicine
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.438
H-Index - 26
eISSN - 2228-7531
pISSN - 2228-7523
DOI - 10.5812/aapm.104705
Subject(s) - medicine , anesthesia , ephedrine , hemodynamics , nausea , vomiting , heart rate , blood pressure , apgar score , caesarean section , sufentanil , pregnancy , gestational age , biology , genetics
Background: The benefit of sequential compression device (SCD) for the prevention of hypotension after spinal anesthesia in cesarean sections has not been determined. Objectives: In this study, an attempt was made to determine whether SCD can prevent hemodynamic changes following spinal anesthesia for cesarean sections. Methods: In a prospective clinical trial, 76 parturient women undergoing elective cesarean sections under spinal anesthesia were randomly divided into SCD or control groups. The maternal hemodynamic changes within 75 min after spinal anesthesia, nausea, vomiting, and neonatal Apgar score at 1 and 5 min were compared between the groups. Results: There were no significant differences between the groups in the patients’ characteristics, maximum sensory block, skin incision to delivery time, spinal anesthesia to delivery time (min), and the total duration of surgery. Concerning heart rate changes, RM ANOVA showed a significant difference in the effect of time, groups, and the interaction of the two factors (P < 0.0001, P < 0.0001, and P < 0.0001, respectively). Tukey post hoc test showed that 3 min after spinal anesthesia, diastolic blood pressure was significantly higher in the SCD group than in the control group (P < 0.05). The SCD group had meaningfully lower rates of nausea (P = 0.005) and vomiting (P = 0.001) than the control group. The SCD group also demonstrated a significantly lower mean ephedrine dosage per patient (4.1 mg against 17.1 mg, P = 0.001). However, no significant difference was observed between the groups in terms of neonatal Apgar scores at 1 and 5 minutes. Conclusions: This study showed that SCD could reduce extensive changes in diastolic blood pressure as an important hemodynamic parameter and the incidence of nausea and vomiting. Thus, SCD can be used in spinal anesthesia care practices for elective cesarean sections.