Prevention of spinal hypotension associated with cesarean section

Abstract

Maternal hypotension during spinal anesthesia for cesarean section is a persistent problem. The authors have studied the effects of fluid loading and left uterine displacement in the prevention of hypotension under three conditions: 1) no fluid loading or left uterine displacement prior to administering spinal anesthesia; 2) fluid loading only; 3) both fluid loading and left uterine displacement by means of a 'Sluder' (sustained left uterine displacer). The fluid infusion alone was as effective as the fluids combined with the 'Sluder' in reducing hypotension in patients not in labor, whereas only the combination of fluids and the 'Sluder' was effective in patients in labor.