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Nonpneumatic Anti-Shock Garment versus Intermittent Sequential Compression Device for Prevention of Postspinal Hypotension in Patients Undergoing Cesarean Section: A Randomized Controlled Study.
Anesth Essays Res 2019 Apr-Jun; 13(2):383-388AE

Abstract

Context

Postspinal hypotension remains a frequent complication of subarachnoid block during cesarean section causing further maternal and fetal adverse effects.

Aims

This study aims to evaluate and compare a continuous pressure nonpneumatic anti-shock garment (NASG) and an intermittent sequential compression device (SCD) with a control group for prevention of postspinal hypotension in women undergoing elective cesarean section.

Settings and Design

A randomized, observer blind, controlled study at single university hospital.

Subjects and Methods

Ninety singleton term parturients between 18 and 35 years of age undergoing cesarean section with spinal anesthesia were randomly assigned to be applied with NASG, SCD, or no device; n = 30 in each group. A standardized protocol for cohydration and anesthetic technique was followed. The primary outcome measure was incidence of hypotension defined as a decrease in systolic blood pressure of more than 20% from baseline or an absolute value <100 mmHg, whichever was higher. The secondary outcome measures were median dose of ephedrine required, incidence of maternal nausea and vomiting, and neonatal Apgar scores.

Statistical Analysis Used

Results were expressed as mean (±standard deviation), median (range), or number (%) as appropriate. Nominal data were compared using Chi-square/Fischer's exact test. Continuous data were compared using ANOVA one-way test. Nonparametric data were compared using Kruskal-Wallis test.

Results

In Groups NASG, SCD, and C, incidence of hypotension was 60%, 83%, and 90%, respectively (P = 0.021), with significant reduction in incidence of hypotension in Group NASG versus Group C (P < 0.001, odds ratio 0.17, 95% confidence interval 0.04-0.68). Median (interquartile range) dose of ephedrine required was significantly less in Group NASG compared with Groups SCD and C, respectively (P = 0.002, P < 0.001).

Conclusions

NASG proved to be a more effective device for prevention of postspinal hypotension when compared with application of SCD or no device.

Authors+Show Affiliations

Department of Anaesthesiology, Pain Medicine and Critical Care, All India Institute of Medical Sciences, New Delhi, India.Department of Anaesthesiology and Critical Care, University College of Medical Sciences and GTB Hospital, New Delhi, India.Department of Anaesthesiology and Critical Care, University College of Medical Sciences and GTB Hospital, New Delhi, India.Department of Anaesthesiology and Critical Care, University College of Medical Sciences and GTB Hospital, New Delhi, India.

Pub Type(s)

Journal Article

Language

eng

PubMed ID

31198264

Citation

Tyagi, Abhay, et al. "Nonpneumatic Anti-Shock Garment Versus Intermittent Sequential Compression Device for Prevention of Postspinal Hypotension in Patients Undergoing Cesarean Section: a Randomized Controlled Study." Anesthesia, Essays and Researches, vol. 13, no. 2, 2019, pp. 383-388.
Tyagi A, Sethi AK, Salhotra R, et al. Nonpneumatic Anti-Shock Garment versus Intermittent Sequential Compression Device for Prevention of Postspinal Hypotension in Patients Undergoing Cesarean Section: A Randomized Controlled Study. Anesth Essays Res. 2019;13(2):383-388.
Tyagi, A., Sethi, A. K., Salhotra, R., & Tyagi, A. (2019). Nonpneumatic Anti-Shock Garment versus Intermittent Sequential Compression Device for Prevention of Postspinal Hypotension in Patients Undergoing Cesarean Section: A Randomized Controlled Study. Anesthesia, Essays and Researches, 13(2), pp. 383-388. doi:10.4103/aer.AER_83_19.
Tyagi A, et al. Nonpneumatic Anti-Shock Garment Versus Intermittent Sequential Compression Device for Prevention of Postspinal Hypotension in Patients Undergoing Cesarean Section: a Randomized Controlled Study. Anesth Essays Res. 2019;13(2):383-388. PubMed PMID: 31198264.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Nonpneumatic Anti-Shock Garment versus Intermittent Sequential Compression Device for Prevention of Postspinal Hypotension in Patients Undergoing Cesarean Section: A Randomized Controlled Study. AU - Tyagi,Abhay, AU - Sethi,Ashok Kumar, AU - Salhotra,Rashmi, AU - Tyagi,Asha, PY - 2019/6/15/entrez PY - 2019/6/15/pubmed PY - 2019/6/15/medline KW - Anesthesia KW - gravity suits KW - hypotension prevention and control KW - intermittent pneumatic compression devices KW - obstetrical anesthesia side effects SP - 383 EP - 388 JF - Anesthesia, essays and researches JO - Anesth Essays Res VL - 13 IS - 2 N2 - Context: Postspinal hypotension remains a frequent complication of subarachnoid block during cesarean section causing further maternal and fetal adverse effects. Aims: This study aims to evaluate and compare a continuous pressure nonpneumatic anti-shock garment (NASG) and an intermittent sequential compression device (SCD) with a control group for prevention of postspinal hypotension in women undergoing elective cesarean section. Settings and Design: A randomized, observer blind, controlled study at single university hospital. Subjects and Methods: Ninety singleton term parturients between 18 and 35 years of age undergoing cesarean section with spinal anesthesia were randomly assigned to be applied with NASG, SCD, or no device; n = 30 in each group. A standardized protocol for cohydration and anesthetic technique was followed. The primary outcome measure was incidence of hypotension defined as a decrease in systolic blood pressure of more than 20% from baseline or an absolute value <100 mmHg, whichever was higher. The secondary outcome measures were median dose of ephedrine required, incidence of maternal nausea and vomiting, and neonatal Apgar scores. Statistical Analysis Used: Results were expressed as mean (±standard deviation), median (range), or number (%) as appropriate. Nominal data were compared using Chi-square/Fischer's exact test. Continuous data were compared using ANOVA one-way test. Nonparametric data were compared using Kruskal-Wallis test. Results: In Groups NASG, SCD, and C, incidence of hypotension was 60%, 83%, and 90%, respectively (P = 0.021), with significant reduction in incidence of hypotension in Group NASG versus Group C (P < 0.001, odds ratio 0.17, 95% confidence interval 0.04-0.68). Median (interquartile range) dose of ephedrine required was significantly less in Group NASG compared with Groups SCD and C, respectively (P = 0.002, P < 0.001). Conclusions: NASG proved to be a more effective device for prevention of postspinal hypotension when compared with application of SCD or no device. SN - 0259-1162 UR - https://www.unboundmedicine.com/medline/citation/31198264/Nonpneumatic_Anti_Shock_Garment_versus_Intermittent_Sequential_Compression_Device_for_Prevention_of_Postspinal_Hypotension_in_Patients_Undergoing_Cesarean_Section:_A_Randomized_Controlled_Study_ L2 - http://www.aeronline.org/article.asp?issn=0259-1162;year=2019;volume=13;issue=2;spage=383;epage=388;aulast=Tyagi DB - PRIME DP - Unbound Medicine ER -