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Lumbar wedge versus pelvic wedge in preventing hypotension following combined spinal epidural anaesthesia for caesarean delivery.
Anaesth Intensive Care. 2008 Nov; 36(6):835-9.AI

Abstract

Aortocaval compression is a major cause of maternal hypotension. A randomised controlled clinical trial was designed to compare two wedged supine positions for prevention of hypotension following combined spinal epidural anaesthesia for caesarean delivery. Sixty parturients undergoing elective caesarean delivery were randomly assigned to two different wedged supine positions. After the completion of subarachnoid injection, parturients were placed with either a wedge under the right pelvis (group P pelvic wedge) or under the right lumbar region (group L, lumbar wedge). Systolic blood pressure and heart rate were recorded every minute for 20 minutes from the subarachnoid injection. Hypotension, defined as systolic blood pressure <100 mmHg or 80% of the baseline, was treated with intravenous ephedrine 5 mg. The incidence of hypotension, ephedrine use and neonatal Apgar scores and umbilical arterial pH were recorded. The incidence of hypotension was significantly higher in group P than that in group L (23/30 [77%] vs. 14/30 [47%], P=0.016). Systolic blood pressure decreased significantly in both groups at seven, eight and nine minutes (P < 0.001); moreover it was lower at seven, eight and nine minutes in group P than in group L (P < 0.01). Heart rate did not change significantly in either group. There were no significant differences between the two groups for Apgar score and umbilical arterial pH. A lumbar wedge is more effective than a pelvic wedge in preventing hypotension following combined spinal epidural anaesthesia for caesarean delivery, although it does not eliminate hypotension.

Authors+Show Affiliations

Department of Anaesthesiology, Jinling Hospital, School of Medicine, Nanjing University, Nanjing, PR China.No affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info available

Pub Type(s)

Comparative Study
Journal Article
Randomized Controlled Trial

Language

eng

PubMed ID

19115653

Citation

Zhou, Z Q., et al. "Lumbar Wedge Versus Pelvic Wedge in Preventing Hypotension Following Combined Spinal Epidural Anaesthesia for Caesarean Delivery." Anaesthesia and Intensive Care, vol. 36, no. 6, 2008, pp. 835-9.
Zhou ZQ, Shao Q, Zeng Q, et al. Lumbar wedge versus pelvic wedge in preventing hypotension following combined spinal epidural anaesthesia for caesarean delivery. Anaesth Intensive Care. 2008;36(6):835-9.
Zhou, Z. Q., Shao, Q., Zeng, Q., Song, J., & Yang, J. J. (2008). Lumbar wedge versus pelvic wedge in preventing hypotension following combined spinal epidural anaesthesia for caesarean delivery. Anaesthesia and Intensive Care, 36(6), 835-9.
Zhou ZQ, et al. Lumbar Wedge Versus Pelvic Wedge in Preventing Hypotension Following Combined Spinal Epidural Anaesthesia for Caesarean Delivery. Anaesth Intensive Care. 2008;36(6):835-9. PubMed PMID: 19115653.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Lumbar wedge versus pelvic wedge in preventing hypotension following combined spinal epidural anaesthesia for caesarean delivery. AU - Zhou,Z Q, AU - Shao,Q, AU - Zeng,Q, AU - Song,J, AU - Yang,J J, PY - 2009/1/1/entrez PY - 2009/1/1/pubmed PY - 2009/2/20/medline SP - 835 EP - 9 JF - Anaesthesia and intensive care JO - Anaesth Intensive Care VL - 36 IS - 6 N2 - Aortocaval compression is a major cause of maternal hypotension. A randomised controlled clinical trial was designed to compare two wedged supine positions for prevention of hypotension following combined spinal epidural anaesthesia for caesarean delivery. Sixty parturients undergoing elective caesarean delivery were randomly assigned to two different wedged supine positions. After the completion of subarachnoid injection, parturients were placed with either a wedge under the right pelvis (group P pelvic wedge) or under the right lumbar region (group L, lumbar wedge). Systolic blood pressure and heart rate were recorded every minute for 20 minutes from the subarachnoid injection. Hypotension, defined as systolic blood pressure <100 mmHg or 80% of the baseline, was treated with intravenous ephedrine 5 mg. The incidence of hypotension, ephedrine use and neonatal Apgar scores and umbilical arterial pH were recorded. The incidence of hypotension was significantly higher in group P than that in group L (23/30 [77%] vs. 14/30 [47%], P=0.016). Systolic blood pressure decreased significantly in both groups at seven, eight and nine minutes (P < 0.001); moreover it was lower at seven, eight and nine minutes in group P than in group L (P < 0.01). Heart rate did not change significantly in either group. There were no significant differences between the two groups for Apgar score and umbilical arterial pH. A lumbar wedge is more effective than a pelvic wedge in preventing hypotension following combined spinal epidural anaesthesia for caesarean delivery, although it does not eliminate hypotension. SN - 0310-057X UR - https://www.unboundmedicine.com/medline/citation/19115653/Lumbar_wedge_versus_pelvic_wedge_in_preventing_hypotension_following_combined_spinal_epidural_anaesthesia_for_caesarean_delivery_ L2 - https://journals.sagepub.com/doi/10.1177/0310057X0803600613?url_ver=Z39.88-2003&amp;rfr_id=ori:rid:crossref.org&amp;rfr_dat=cr_pub=pubmed DB - PRIME DP - Unbound Medicine ER -