PAKISTAN ARMED FORCES
MEDICAL JOURNAL (Category Y)

A Journal of Army Medical & Dental Corps

Being published since 1956

ISSN (online) 2411-8842
ISSN (print) 0030-9648

VOL 68, No. 1, FEBRURAY 2018

COMPARISON OF THE HEMODYNAMIC EFFECTS OF LATERAL AND SITTING POSITIONS DURING INDUCTION OF SPINAL ANAESTHESIA FOR CAESAREAN SECTION USING HYPERBARIC BUPIVACAINE

Muhammad Ali, Asjad Sharif*, Syed Ehtesham Haider Naqvi**

Abstract

Objective: To compare the frequency of hypotension of sitting versus lateral position during induction of spinal anesthesia for elective LSCS using Hyperbaric Bupivacaine.
Study Design: Randomized control trial.
Place and Duration of Study: The study was conducted at Military Hospital Rawalpindi, a tertiary care hospital, after seeking hospital ethics committee permission. Study was carried out for six months, from Nov 2014 to May 2015.
Patient and Methods: A total of 130 participants achieving the inclusion criteria were picked up for this study. Patients were randomized into group-S and group-L (65 in each group). Group-S received spinal anesthesia using 0.75% hyperbaric Bupivacaine in sitting position and group-L in left lateral position. Maternal Blood pressure was measured before Induction (baseline) and every 3 min after subarachnoid injection for 15 min and final outcome measured at 15 minutes. Decrease in systolic blood pressure of >20% from baseline or a value <90 mmHg was
considered as hypotension.
Results: The age of the patients ranged between 25-35 years. Average age of participants were 29.18 ± 2.80 and 29.12 ± 2.52 in group S & L, respectively. In group-S hypotension developed in 34 patients (52.3%) and in group-L hypotension was observed in 20 patients (30.7%), (p=0.013). Mean weight in group-S was 71.77 ± 2.82 and in group-L was 70.91 ± 2.05. Stratification with regard to age and ASA status was carried out.
Conclusion: Occurrence of Hypotension was significantly less frequent when spinal anesthesia was induced to patients in the left lateral position, for elective caesarean using 0.75% Hyperbaric Bupivacaine compared to the sitting position.

Keywords : Caesarean section, Hemodynamic Effects, Inducing position, Spinal anesthesia



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