Tags

Type your tag names separated by a space and hit enter

Influence of a prolonged lateral position on induction of spinal anesthesia for cesarean delivery: a randomized controlled trial.
Minerva Anestesiol. 2012 Jun; 78(6):646-52.MA

Abstract

BACKGROUND

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.

METHODS

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.

RESULTS

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.

CONCLUSION

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.

Authors+Show Affiliations

Department of Anesthesiology and Pain Medicine, Seoul National University Bundang Hospital, Seongnam, South Korea.No affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info available

Pub Type(s)

Journal Article
Randomized Controlled Trial

Language

eng

PubMed ID

22410469

Citation

Hwang, J W., et al. "Influence of a Prolonged Lateral Position On Induction of Spinal Anesthesia for Cesarean Delivery: a Randomized Controlled Trial." Minerva Anestesiologica, vol. 78, no. 6, 2012, pp. 646-52.
Hwang JW, Oh AY, Song IA, et al. Influence of a prolonged lateral position on induction of spinal anesthesia for cesarean delivery: a randomized controlled trial. Minerva Anestesiol. 2012;78(6):646-52.
Hwang, J. W., Oh, A. Y., Song, I. A., Na, H. S., Ryu, J. H., Park, H. P., Jeon, Y. T., & Do, S. H. (2012). Influence of a prolonged lateral position on induction of spinal anesthesia for cesarean delivery: a randomized controlled trial. Minerva Anestesiologica, 78(6), 646-52.
Hwang JW, et al. Influence of a Prolonged Lateral Position On Induction of Spinal Anesthesia for Cesarean Delivery: a Randomized Controlled Trial. Minerva Anestesiol. 2012;78(6):646-52. PubMed PMID: 22410469.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Influence of a prolonged lateral position on induction of spinal anesthesia for cesarean delivery: a randomized controlled trial. AU - Hwang,J W, AU - Oh,A Y, AU - Song,I A, AU - Na,H S, AU - Ryu,J H, AU - Park,H P, AU - Jeon,Y T, AU - Do,S H, Y1 - 2012/03/13/ PY - 2012/3/14/entrez PY - 2012/3/14/pubmed PY - 2012/10/31/medline SP - 646 EP - 52 JF - Minerva anestesiologica JO - Minerva Anestesiol VL - 78 IS - 6 N2 - BACKGROUND: 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. METHODS: 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. RESULTS: 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. CONCLUSION: 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. SN - 1827-1596 UR - https://www.unboundmedicine.com/medline/citation/22410469/Influence_of_a_prolonged_lateral_position_on_induction_of_spinal_anesthesia_for_cesarean_delivery:_a_randomized_controlled_trial_ L2 - http://www.minervamedica.it/index2.t?show=R02Y2012N06A0646 DB - PRIME DP - Unbound Medicine ER -