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Maternal Position and Development of Hypotension in Patients undergoing Cesarean Section under Combined Spinal–Epidural Anesthesia of Intrathecal Hyperbaric Ropivacaine

Xin Wang, Jun-Mei Xu, Fan Zhou, Liang He, Yu-Long Cui, Zhi-Jian Li

(Department of Anesthesiology, Second Xiangya Hospital, Central South University, Changsha, Hunan, China (mainland))

Med Sci Monit 2015; 21:52-58

DOI: 10.12659/MSM.892224


Background: Spinal anesthesia (SA) is usually associated with hypotension in pregnant women. We sought to assess the influence of various maternal positions on SA-induced hypotension
Material and Methods: The study population comprised 99 women at full-term gestation scheduled for elective cesarean section. They were randomized into 3 equal groups: the LL group, in which the patient was placed in the full left-lateral position until the start of surgery with the Whitacre needle bevel oriented laterally; the LS group, in which the patient was placed in the full left-lateral position initially and then shifted to the left-tilt supine position with the needle bevel oriented laterally; and the CS group, in which the patient was initially placed in the full left-lateral position and then shifted to the left-tilt supine position with the needle oriented in the cephalad direction.
Results: The incidences of hypotension in the LL, LS, and CS groups were 9.7%, 54.8%, and 56.3%, respectively. Ephedrine requirements were lower in the LL group than in the LS group (P<0.01).
Conclusions: The maternal position during the induction of anesthesia played an important role in the development of hypotension during cesarean delivery.

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