A study to evaluate hemodynamic effects of lateral and sitting position during induction of spinal anesthesia for lower segment caesarean section

Abstract

Background: Regional anesthesia is preferred by most anesthesiologists for the majority of caesarean sections. Sympathetic block and hypotension as a result of spinal anesthesia can cause hypoperfusion of the uterus and placenta. The aim of our study was to compare hemodynamic parameters during left lateral and sitting positions during spinal anesthesia to facilitate lower segment caesarean sections. Methods: One hundred twenty-two ASA physical status I and II parturients undergoing elective lower segment caesarean sections were randomly allocated to group A (Sitting) and group B (Left lateral) and given 2 ml (10 mg) of 0.5% hyperbaric bupivacaine each in L 3-4 interspace. Blood pressure, heart rate and oxygen saturation were recorded. Time taken to achieve sensory level, time to onset of first episode of hypotension, total number of episodes of hypotension, total dose of ephedrine consumed, umbilical artery pH and neonatal APGAR scores at one and five minutes were recorded. Results: The time taken to achieve T 4 sensory level and time to first episode of hypotension were significantly more in sitting position (p=0.00). The number of patients experiencing hypotension, number of hypotensive episodes and total ephedrine requirement were significantly more in lateral position (p<0.05). Neonatal outcome was comparable in both the groups. Conclusion: While adequate sensory level for caesarean section is attained quicker in left lateral position as compared to sitting position, hemodynamic stability is better in sitting position. However, neonatal outcome is comparable in both the positions.