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Leg elevation decreases the incidence of post-spinal hypotension in cesarean section: a randomized controlled trial.
BMC Anesthesiol 2017; 17(1):60BA

Abstract

BACKGROUND

Maternal hypotension is a common complication after spinal anesthesia for cesarean section (CS). In this study we investigated the role of leg elevation (LE) as a method for prevention of post-spinal hypotension (PSH) for cesarean section.

METHODS

One hundred and fifty full term parturients scheduled for CS were included in the study. Patients were randomized into two groups: Group LE (leg elevation group, n = 75) and group C (Control group, n = 75). Spinal block was performed in sitting position after administration of 10 mL/Kg Ringer's lactate as fluid preload. After successful intrathecal injection of local anesthetic, Patients were positioned in the supine position. Leg elevation was performed for LE group directly after spinal anesthesia and maintained till skin incision. Intraoperative hemodynamic parameters (Arterial blood pressure and heart rate), intra-operative ephedrine consumption, incidence of PSH, and incidence of nausea and vomiting were reported.

RESULTS

LE group showed lower incidence of PSH (34.7% Vs 58.7%, P = 0.005) compared to the control group. Arterial blood pressure was higher in the LE group compared to the control group in the first two readings after spinal block. Other readings showed comparable arterial blood pressure and heart rate values between both study groups; however, LE showed less ephedrine consumption (4.9 ± 7.8 mg Vs 10 ± 11 mg, P = 0.001).

CONCLUSION

LE performed immediately after spinal block reduced the incidence of PSH in parturients undergoing CS.

TRIAL REGISTRATION

The study was registered at Pan African Clinical Trials Registry system on 5/10/2015 with trial number PACTR201510001295348 .

Authors+Show Affiliations

Department of Anesthesia and Critical Care Medicine, Cairo University, Cairo, Egypt.Department of Anesthesia and Critical Care Medicine, Cairo University, Cairo, Egypt.Department of Anesthesia and Critical Care Medicine, Cairo University, Cairo, Egypt.Department of Anesthesia and Critical Care Medicine, Cairo University, Cairo, Egypt.Department of Obstetrics and Gynecology, Cairo University, Cairo, Egypt.Department of Anesthesia and Critical Care Medicine, Cairo University, Cairo, Egypt.Department of Anesthesia and Critical Care Medicine, Cairo University, Cairo, Egypt.Department of Anesthesia and Critical Care Medicine, Cairo University, Cairo, Egypt.Department of Anesthesia and Critical Care Medicine, Cairo University, Cairo, Egypt. yalnaby@yahoo.com.

Pub Type(s)

Journal Article
Randomized Controlled Trial
Research Support, Non-U.S. Gov't

Language

eng

PubMed ID

28438121

Citation

Hasanin, Ahmed, et al. "Leg Elevation Decreases the Incidence of Post-spinal Hypotension in Cesarean Section: a Randomized Controlled Trial." BMC Anesthesiology, vol. 17, no. 1, 2017, p. 60.
Hasanin A, Aiyad A, Elsakka A, et al. Leg elevation decreases the incidence of post-spinal hypotension in cesarean section: a randomized controlled trial. BMC Anesthesiol. 2017;17(1):60.
Hasanin, A., Aiyad, A., Elsakka, A., Kamel, A., Fouad, R., Osman, M., ... Hassabelnaby, Y. (2017). Leg elevation decreases the incidence of post-spinal hypotension in cesarean section: a randomized controlled trial. BMC Anesthesiology, 17(1), p. 60. doi:10.1186/s12871-017-0349-8.
Hasanin A, et al. Leg Elevation Decreases the Incidence of Post-spinal Hypotension in Cesarean Section: a Randomized Controlled Trial. BMC Anesthesiol. 2017 04 24;17(1):60. PubMed PMID: 28438121.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Leg elevation decreases the incidence of post-spinal hypotension in cesarean section: a randomized controlled trial. AU - Hasanin,Ahmed, AU - Aiyad,Ahmed, AU - Elsakka,Ahmed, AU - Kamel,Atef, AU - Fouad,Reham, AU - Osman,Mohamed, AU - Mokhtar,Ali, AU - Refaat,Sherin, AU - Hassabelnaby,Yasmin, Y1 - 2017/04/24/ PY - 2016/09/22/received PY - 2017/04/10/accepted PY - 2017/4/26/entrez PY - 2017/4/26/pubmed PY - 2017/11/8/medline KW - Cesarean section KW - Hypotension KW - Leg elevation KW - Spinal anesthesia SP - 60 EP - 60 JF - BMC anesthesiology JO - BMC Anesthesiol VL - 17 IS - 1 N2 - BACKGROUND: Maternal hypotension is a common complication after spinal anesthesia for cesarean section (CS). In this study we investigated the role of leg elevation (LE) as a method for prevention of post-spinal hypotension (PSH) for cesarean section. METHODS: One hundred and fifty full term parturients scheduled for CS were included in the study. Patients were randomized into two groups: Group LE (leg elevation group, n = 75) and group C (Control group, n = 75). Spinal block was performed in sitting position after administration of 10 mL/Kg Ringer's lactate as fluid preload. After successful intrathecal injection of local anesthetic, Patients were positioned in the supine position. Leg elevation was performed for LE group directly after spinal anesthesia and maintained till skin incision. Intraoperative hemodynamic parameters (Arterial blood pressure and heart rate), intra-operative ephedrine consumption, incidence of PSH, and incidence of nausea and vomiting were reported. RESULTS: LE group showed lower incidence of PSH (34.7% Vs 58.7%, P = 0.005) compared to the control group. Arterial blood pressure was higher in the LE group compared to the control group in the first two readings after spinal block. Other readings showed comparable arterial blood pressure and heart rate values between both study groups; however, LE showed less ephedrine consumption (4.9 ± 7.8 mg Vs 10 ± 11 mg, P = 0.001). CONCLUSION: LE performed immediately after spinal block reduced the incidence of PSH in parturients undergoing CS. TRIAL REGISTRATION: The study was registered at Pan African Clinical Trials Registry system on 5/10/2015 with trial number PACTR201510001295348 . SN - 1471-2253 UR - https://www.unboundmedicine.com/medline/citation/28438121/Leg_elevation_decreases_the_incidence_of_post_spinal_hypotension_in_cesarean_section:_a_randomized_controlled_trial_ L2 - https://bmcanesthesiol.biomedcentral.com/articles/10.1186/s12871-017-0349-8 DB - PRIME DP - Unbound Medicine ER -