Comparison between 2, 4 and 6 Minute Sitting Positions versus Immediately Lying Down on Hemodynamic Variables, Fluid and Ephedrine Requirement after Spinal Anesthesia in Elective Cesarean Section

2019 
Background: hypotension is one of the most common complications of spinal anesthesia in patients undergoing cesarean section. In this regard, the patient’s position may affect the incidence of hypotension. Objective: to compare the incidence of hypotension and ephedrine requirement after spinal anesthesia with variable time in sitting position before lying down. Patients and Methods: a total of 100 patients, scheduled for cesarean section under spinal anesthesia, with 10 mg of hyperbaric bupivacaine 0.5% (2 ml) mixed with 25 µg (0.5 ml) fentanyl, were randomly divided into 4 groups (25 patients per group). Groups M2, M4 and M6 remained in a sitting position for 2, 4 and 6 minutes after the induction of spinal anesthesia, respectively, while group M0 was immediately placed in a lying position. Results: there were highly significant differences between the four groups as regard the incidence of hypotension based on Chi-square test; **p-value <0.001 HS. The frequency of hypotension was higher in group M0 in comparison with other groups. There was high consumption of ephedrine and fluid in group M0 than other groups as the total dose used in group M0 was bigger than other groups while M6 had the smaller dose. Conclusion: the present study revealed that the patient’s position is an important factor, which affects the frequency of hypotension, ephedrine and fluid requirements, and the onset of sensory block during the administration of spinal anesthesia for cesarean section.
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