A study to evaluate the efficacy of left lateral tilt in preventing hypotension after spinal anesthesia in elective caeserian section patients
Keywords:C-section, Hypotension, Left lateral tilts, Cardiac output, Spinal anesthesia.
Introduction: During caesarean delivery, post-spinal hypotension is a typical complication among women. Post-spinal hypotension is thought to be caused by Aortocaval compression caused by the fetus. It's unknown whether left lateral tilting improves maternal cardiac output following “subarachnoid block (SAB)”. The goal of this study is to see the efficacy of the left lateral tilting in preventing hypotension after spinal anesthesia in elective C- section patients . Material and Methods: We piloted a prospective study with 50 age matched subjects admitted for the C-section. The clinical findings like systemic vascular resistance, stroke volume, cardiac output, heart rate and Mean arterial pressure that are affected at the various lateral tilts of (30º,15º) were compared to supine position. The values were collected preoperatively, after the SAB and after the delivery. The data was analyzed using the ANOVA test deliberating P<0.05 as significant. Results: We observed no significant difference in the cardiac parameters before the surgery between the supine and for the lateral tilt angles of 15 and 30 degrees. However after the anesthesia significant variation of the cardiac parameters was noted in the supine position than supine position before the SAB. While after the SAB in the lateral tilt the MAP, Cardiac output, and Stroke volume were significantly greater compared to the supine position at both the angles of the left tilts. There was no difference in the values between the two tilt positions. After the delivery MAP, Cardiac output, and Stroke volume significantly increased in the supine position while the heart rate lowered significantly compared to the supine position after the SAB. Conclusions: The hypotension commonly seen among the pregnant women after the SAB can be prevented by the lateral tilt positions at both the 150 and 300 angles. Hence this position is encouraged for the after the C-section.
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Copyright (c) 2022 Shrinivas T R, Liyakhath Ali, Gopal V Gotur
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