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

Hemodynamic Effects of Spinal Anaesthesia

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.
Patients 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.